Why does this page start at 1 unit (EA)?

NADAC prices this product per EA, and the FDA NDC Directory lists 1 of its 2 NDCs (it does not list the other one) as dosage form “SPRAY” with route “NASAL”. Only a tablet, capsule, lozenge or troche with route “ORAL”, or a tablet or film with route “SUBLINGUAL” or “BUCCAL”, starts at 30, and this is not one. NADAC’s EA for it may be a whole package (such as a kit, pen, syringe, vial or inhaler) or one dose inside it, and the files do not say which. So the card starts at 1 unit (EA) rather than guess how many make up a fill; change it to match your prescription.

CYANOCOBALAMIN 500 MCG SPRAY

For 1 unit (EA)

Pharmacies pay

$95.91 filed

1 × $95.90838 per EA

CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17

Medicare

We don’t know yet

No Medicare reference price. Part D: OpenBill did not match this NDC to a usable Medicare Part D spending row. Either Part D has none for it, or the rows that share its name could not safely be tied to it (for example, they mix units, routes or release forms, or the drug is sold over the counter, which Part D does not cover). Part B: This NDC is not in the current quarter’s Medicare Part B NDC-HCPCS crosswalk, so it has no Part B payment limit.

The spread

We don’t know yet

There is no Medicare figure to compare with, so there is no spread.

Cost-plus estimate

$115.30 estimated

$95.91 + $14.39 (15%) + $5.00 fee per fill = $115.30

This is a model, not a price any pharmacy quoted. Shipping is not included. How it is worked out

OpenBill calculation · nadac-national-average-drug-acquisition-cost-20261014.csv · NADAC eff. 2026-09-23 (file of 2026-10-14, retrieved 2026-10-17)

Open the interactive card Change the quantity, type what you were charged, and see every record in full.

What it is

CYANOCOBALAMIN 500 MCG SPRAY is how the CMS NADAC file names this product. The FDA NDC Directory lists it as cyanocobalamin.

FDA gives its dosage form as spray and its route as nasal.

The labeler, the company named on the label, is Padagis Israel Pharmaceuticals Ltd.

FDA’s Established Pharmacologic Class for it is Vitamin B12.

The NADAC file of 2026-10-14 prices it under 2 NDCs (National Drug Codes); the FDA directory lists 1 of them.

NADAC classes it as a generic drug (rate-setting class G), and does not mark it as sold over the counter.

What pharmacies pay

Pharmacies pay $95.91 for 1 unit (EA) (1 × $95.90838 per EA, rounded to the cent), by the CMS NADAC file of 2026-10-14; that price took effect on 2026-09-23. That is what pharmacies pay their suppliers, not what they charge you.

NADAC’s explanation codes for it: 1, calculated from the most recently completed pharmacy survey; 5, calculated based on package size.

What NADAC measures · NADAC explanation codes

All 2 NDCs

43386-0237-70 · not listed as a package in the FDA directory · $95.90838 per EA · eff. 2026-09-23 filed
45802-0491-84 · Padagis Israel Pharmaceuticals Ltd · $95.90838 per EA · eff. 2026-09-23 filed

Other strengths, forms and brands

3 other products in the NADAC file share the FDA nonproprietary name cyanocobalamin with CYANOCOBALAMIN 500 MCG SPRAY.

Product	Pharmacies pay per unit	Medicare per unit
CYANOCOBALAMIN 1,000 MCG/ML VL generic · injection / injection, solution	$1.47387 to $2.97018 per ML filed eff. 2026-09-23	$0.648 per ML derived Part B limit 2026 Q4
CYANOCOBALAMIN 10,000 MCG/10 ML generic · injection / injection, solution	$0.73861 to $2.97018 per ML filed eff. 2026-09-23	$0.648 per ML derived Part B limit 2026 Q4
CYANOCOBALAMIN 30,000 MCG/30 ML generic · injection / injection, solution	$0.32805 to $0.78707 per ML filed eff. 2026-02-18 to 2026-09-23	$0.648 per ML derived Part B limit 2026 Q4
CYANOCOBALAMIN 500 MCG SPRAY this page generic · spray	$95.90838 per EA filed eff. 2026-09-23	We don’t know yet

CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-02-18, 2026-09-23 · as of 2026-10-14 · retrieved 2026-10-17

OpenBill calculation · october-2026-medicare-part-b-payment-limit-files-final.zip + october-2026-ndc-hcpcs-crosswalk-final.zip · Part B limit 2026-10-01 to 2026-12-31 (file of 2026-09-17, retrieved 2026-10-18) · Part B crosswalk 2026-10-01 to 2026-12-31 (file of 2026-09-17, retrieved 2026-10-18)

Compared with its class

The middle of its 2 NDCs’ NADAC prices is $95.90838 per EA filed.

Of the 20 other products in FDA’s Vitamin B12 class priced per EA, 0 have a higher middle NADAC price and 20 a lower one. The one in the middle is CONCEPT DHA CAPSULE, at $1.161 per EA filed (eff. 2026-10-01).

Prices are compared per unit, whatever the strength or dose, and a class is not a list of substitutes.

CMS NADAC · nadac-national-average-drug-acquisition-cost-20261014.csv · eff. 2026-09-23, 2026-10-01 · as of 2026-10-14 · retrieved 2026-10-17

How the class comparison works

What Medicare paid

We don’t know yet; the card above says why.

Which Medicare figure OpenBill compares · How Part D is matched · How Part B is matched

What to ask at the counter

None of these figures is your price: what you pay depends on your pharmacy, your insurance, coupons and discounts.

What is your cash price for 1 unit (EA)? Is it lower than what I would pay through my insurance?
These are questions about price, not medical advice. Do not change or stop a medicine without talking to your prescriber or pharmacist.

Questions

Why does this page start at 1 unit (EA)?: NADAC prices this product per EA, and the FDA NDC Directory lists 1 of its 2 NDCs (it does not list the other one) as dosage form “SPRAY” with route “NASAL”. Only a tablet, capsule, lozenge or troche with route “ORAL”, or a tablet or film with route “SUBLINGUAL” or “BUCCAL”, starts at 30, and this is not one. NADAC’s EA for it may be a whole package (such as a kit, pen, syringe, vial or inhaler) or one dose inside it, and the files do not say which. So the card starts at 1 unit (EA) rather than guess how many make up a fill; change it to match your prescription.

Its pharmacologic class

Vitamin B12 26 products