Poly-hist Dm
Pricing Report NDC 50991-220-16
Current Package Pricing Information
The latest wholesale acquisition cost for Poly-hist Dm (NDC 50991-220-16) is $0.16026 per ML. This benchmark price is based on the National Average Drug Acquisition Cost (NADAC) and has been effective since Jun 18, 2025.
As a provided by Poly Pharmaceuticals, Inc., this medication is distributed in a 473 mL in 1 BOTTLE configuration. The pricing data is derived from C/I - Chain or Independent Pharmacy surveys, reflecting the actual invoice prices paid by community pharmacies to drug wholesalers.
NADAC Pricing Summary
NADAC pricing snapshot for this package NDC
Acquisition Cost $0.16026 Per ML
The NADAC was calculated based on package size.
Historical Pricing Trends & Acquisition Cost Benchmarks
Since Feb 2016, the NADAC wholesale price for (NDC ) has moved within a range of $0.15796 to $0.16364 per ML. Over this 9 years and 4 months period, the pricing trend reflects the shifting acquisition costs reported by retail and chain pharmacies to the Centers for Medicare and Medicaid Services (CMS). The following interactive chart and historical table detail every recorded price adjustment based on these federal surveys.
$0.1580 - $0.1636
3.60% Variance
No Change
| Date | Unit Price | Unit | Source | Method | Rate |
|---|---|---|---|---|---|
| Jun 18, 2025 | $0.16026 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Jun 18, 2025 | $0.16026 | ML | C/I - Chain or Independent Pharmacy | Code 4, 5 | G - Generic |
| May 21, 2025 | $0.16026 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 23, 2025 | $0.15982 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Mar 19, 2025 | $0.15938 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Feb 19, 2025 | $0.15938 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Jan 22, 2025 | $0.15977 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Dec 18, 2024 | $0.16064 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Nov 20, 2024 | $0.16016 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Oct 23, 2024 | $0.16113 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Sep 18, 2024 | $0.15972 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Aug 21, 2024 | $0.16007 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Jul 17, 2024 | $0.16136 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Jun 19, 2024 | $0.16145 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| May 22, 2024 | $0.16034 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 17, 2024 | $0.16011 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 22, 2020 | $0.16177 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 22, 2020 | $0.16177 | ML | C/I - Chain or Independent Pharmacy | Code 4, 5 | G - Generic |
| Apr 18, 2018 | $0.16072 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 18, 2018 | $0.16072 | ML | C/I - Chain or Independent Pharmacy | Code 4, 5 | G - Generic |
| Mar 21, 2018 | $0.16250 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Feb 21, 2018 | $0.16150 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Jan 17, 2018 | $0.15796 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 19, 2017 | $0.15938 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Apr 19, 2017 | $0.15938 | ML | C/I - Chain or Independent Pharmacy | Code 4, 5 | G - Generic |
| May 18, 2016 | $0.16070 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| May 18, 2016 | $0.16070 | ML | C/I - Chain or Independent Pharmacy | Code 4, 5 | G - Generic |
| Feb 17, 2016 | $0.16364 | ML | C/I - Chain or Independent Pharmacy | Code 1, 5 | G - Generic |
| Feb 17, 2016 | $0.16364 | ML | C/I - Chain or Independent Pharmacy | Code 4, 5 | G - Generic |
Pricing Methodology Legend
- Code 1: The NADAC was calculated using information from the most recently completed pharmacy survey.
- Code 4: The NADAC was carried forward from the previous file.
- Code 5: The NADAC was calculated based on package size.
Understanding NADAC Pricing Data
The National Average Drug Acquisition Cost (NADAC) is compiled by the Centers for Medicare and Medicaid Services (CMS). This data is derived from random monthly surveys of more than 60,000 pharmacies across all 50 states.
Important Price Distinction:
The prices listed on this page represent the wholesale invoice price paid by pharmacies to acquire the drug. This is NOT the retail price paid by consumers at the pharmacy counter. Final patient costs typically include pharmacy markups, professional dispensing fees, and insurance adjustments.
NADAC Pricing Data Last Updated on: July 08, 2026
