Pricing NDC 0642-0093-30 Vitafol Ultra

Doconexent, Niacinamide, .alpha.-tocopherol Acetate, Dl-, Cholecalciferol, .beta.-carotene, Ascorbic Acid, Thiamine Mononitrate, Riboflavin, Pyridoxine Hydrochloride, Cyanocobalamin, Iron, Zinc Oxide, Cupric Oxide, Potassium Iodide, Magnesium Oxide, Folic Acid, And Levomefolate Calcium

Current Pricing for NDC Package Code 0642-0093-30

The most recent wholesale price for NDC Code 0642-0093-30 is $4.01927 for each billable unit. A package of 5 blister pack in 1 box > 6 capsule, liquid filled in 1 blister pack of Vitafol Ultra, a human prescription drug labeled by Exeltis Usa, Inc. is priced per "EA" unit. The pricing information is based on the National Average Drug Acquisition Cost (NADAC) and is effective since 01-01-2022.

NADAC pricing data is based on random monthly surveys and reflects the average drug invoice price paid by retail community pharmacies to wholesalers. The data source for this pricing survey was a C/I - Chain or Independent Pharmacy.

Field Name Field Value
Price per Unit $4.01927
Effective Date 01-01-2022 Effective Date
The effective date of the NADAC Per Unit cost.
Pricing Unit EA Pricing Unit
Indicates the pricing unit for the associated NDC (ML, GM or EA).
Pharmacy Type Indicator C/I - Chain or Independent Pharmacy Pharmacy Type Indicator
The source of pharmacy survey data used to calculate the NADAC. 'C/I' indicates data was collected from surveys of Chain/Independent pharmacies. Other pharmacy type indicators are not used at this time.
Explanation Code Code 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation. Explanation Code
The source of pharmacy survey data used to calculate the NADAC. 'C/I' indicates data was collected from surveys of Chain/Independent pharmacies. Other pharmacy type indicators are not used at this time.
Classification for Rate Setting B - Brand Classification for Rate Setting
Indicates whether the NDC was considered brand (B) or generic (G) for the NADAC rate calculation process. If the NDC was considered brand (B) and approved under an Abbreviated New Drug Application (ANDA), the indicator is shown as (B-ANDA).
As of Date 01-19-2022

The Centers for Medicare and Medicaid Services (CMS) compile the NADAC data based on random monthly surveys on more than 60,000 pharmacies from all 50 states and the District of Columbia. NADAC pricing information is NOT the price paid by end-customers but instead the price paid by pharmacies to drug wholesalers and distributors.

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Pricing History for NDC Package Code 0642-0093-30

The following visualiztion reflects the pricing trend of Vitafol Ultra

The NADAC wholesale price of Vitafol Ultra 0642-0093-30 has fluctuated from a low of $2.34333 to a high of $4.01927 per billable unit over a period of 7 years and 10 months. The historical price table below includes all the price changes based on the monthly surveys of retail and chain pharmacies taken by the Centers for Medicare and Medicaid Services (CMS).

Effective Date Price per Unit Pricing Unit Pharmacy Type Indicator Explanation Code Classification Rate Setting
01-01-2022$4.01927EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
12-22-2021$3.92353EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
04-21-2021$3.93738EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
06-17-2020$3.92940EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
08-21-2019$3.92486EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
10-17-2018$3.95710EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
01-01-2018$3.95140EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
11-22-2017$3.62524EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
02-22-2017$3.63270EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
01-09-2017$3.63822EAC/I - Chain or Independent PharmacyCode 3: The NADAC based on survey data has been adjusted to reflect changes in published pricing, or as a result of an inquiry to the help desk.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
05-26-2016$3.33767EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
12-23-2015$3.05164EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
03-01-2015$3.07084EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
10-22-2014$2.79175EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
08-15-2014$2.82393EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
04-23-2014$2.56725EAC/I - Chain or Independent PharmacyCode 2: The average acquisition cost of the most recent survey was within ± 2% of the current NADAC; therefore, the NADAC was carried forward from the previous file.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
04-01-2014$2.57767EAC/I - Chain or Independent PharmacyCode 3: The NADAC based on survey data has been adjusted to reflect changes in published pricing, or as a result of an inquiry to the help desk.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand
03-19-2014$2.34333EAC/I - Chain or Independent PharmacyCode 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
Code 6: The CMS Covered Outpatient File drug category type of S/I/N (Single Source/Innovator/Non-Innovator) has not been applied. Most S/I drugs with the same strength, dosage form and route of administration were grouped together for the purpose of the NADAC calculation and N drugs were also grouped together. In some cases, however, in calculating a NADAC, the CMS S/I/N designation was not applied when the state Medicaid brand or generic payment practices for these drugs generally differed from the CMS Covered Outpatient File designation.
B - Brand

The pricing data in this page is based on the National Average Drug Acquisition Cost (NADAC). The NADAC data is compiled by CMS and updated every week. The NADAC dataset is designed to help create a national benchmark reflective of the wholesale prices paid by retails pharmacies to acquire prescription and over-the-counter drugs. The pricing information in this page reflects the reference point that healthcare programs like Medicaid may use to reimburse pharmacies. The pricing data is this page is NOT the price paid by end-customers.

NADAC Pricing Data Last Updated on: 01-19-2022