Prometh With Dextromethorphan
NDC Package 0472-1630-28

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

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was discontinued by the firm.

Prometh With Dextromethorphan is a . Marketed by Actavis Pharma, Inc., this product is identified by NDC 0472-1630 and is authorized under FDA application ANDA088762.

Identification & Billing

NDC Package Code
0472-1630-28
Package Description
3785 mL in 1 BOTTLE
Product Code
0472-1630
11-Digit Billing Format
00472163028

Clinical Specifications

Proprietary Name
Prometh With Dextromethorphan
Dosage Form
-

Regulatory & Marketing

Labeler Name
Actavis Pharma, Inc.
FDA Application #
ANDA088762
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
01-03-2007
End Marketing Date
05-31-2011
Listing Expiration
05-31-2011
Exclude Flag
D
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (0472-1630). Click a package code to view its specific billing and regulatory data.

0472-1630-04
118 mL in 1 BOTTLE
0472-1630-16
473 mL in 1 BOTTLE

* 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 0472-1630-28 identifies a specific commercial package of 3785 ml in 1 bottle of Prometh With Dextromethorphan, labeled by Actavis Pharma, Inc.. 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 Actavis Pharma, Inc. on January 03, 2007. The current certification is valid through May 31, 2011.

How is this Actavis Pharma, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00472163028. 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)
0472-1630-28
11-Digit CMS (5-4-2)
00472-1630-28

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