Wal-som
NDC Package 0363-0223-02

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Wal-som is adults and children 12 years of age and over:2 Rapidmelt (25mg each) at bedtime if needed, or as directed by a doctorPlace 2 tablets on to tongue; tablets dissolve with or without waterallow tablets to dissolve in mouth or chew before swallowing. Marketed by Walgreen, this product is identified by NDC 0363-0223 and is authorized under FDA application part338.

Identification & Billing

NDC Package Code
0363-0223-02
Package Description
4 BLISTER PACK in 1 CARTON / 6 TABLET in 1 BLISTER PACK (0363-0223-01)
Product Code
0363-0223
11-Digit Billing Format
00363022302
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
4 EA
RxNorm Crosswalk
  • RxCUI: 1093098 - diphenhydrAMINE HCl 25 MG Disintegrating Oral Tablet
  • RxCUI: 1093098 - diphenhydramine hydrochloride 25 MG Disintegrating Oral Tablet
  • RxCUI: 1437725 - Wal-Som 25 MG Disintegrating Oral Tablet
  • RxCUI: 1437725 - diphenhydramine hydrochloride 25 MG Disintegrating Oral Tablet [Wal-Som]

Clinical Specifications

Proprietary Name
Wal-som
Dosage Form
-
Usage Information
Adults and children 12 years of age and over:2 Rapidmelt (25mg each) at bedtime if needed, or as directed by a doctorPlace 2 tablets on to tongue; tablets dissolve with or without waterallow tablets to dissolve in mouth or chew before swallowing

Regulatory & Marketing

Labeler Name
Walgreen
FDA Application #
part338
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
08-22-2012
Listing Expiration
12-31-2017
Exclude Flag
I
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 0363-0223-02 identifies a specific commercial package of 4 blister pack in 1 carton / 6 tablet in 1 blister pack (0363-0223-01) of Wal-som, labeled by Walgreen. This product is billed for "EA" each discreet unit and contains an estimated amount of 4 billable units per package. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Walgreen on August 22, 2012. The current certification is valid through December 31, 2017.

How is this Walgreen product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00363022302. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 4 total billable units per package. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (4-4-2)
0363-0223-02
11-Digit CMS (5-4-2)
00363-0223-02

Note: The zero is added to the Labeler segment to maintain the 5-4-2 structure.