Actidose Aqua Suspension
NDC Package 0574-0521-76

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

Actidose Aqua (activated charcoal) suspension is •Shake well.•Unscrew cap and remove foil. This formulation utilizes a suspension delivery system. Marketed by Padagis Us Llc, this product is identified by NDC 0574-0521 and is authorized under FDA application M023.

Identification & Billing

NDC Package Code
0574-0521-76
Package Description
240 mL in 1 TUBE
Product Code
0574-0521
11-Digit Billing Format
00574052176
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
Units Per Package
240 ML
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Actidose Aqua
Non-Proprietary Name
Activated Charcoal
Substance Name
Activated Charcoal
Dosage Form
Suspension - A liquid1 dosage form that contains solid particles dispersed in a liquid vehicle.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
ACTIVATED CHARCOAL 208 mg/mL
Usage Information
•Shake well.•Unscrew cap and remove foil. Replace cap to administer.•If delivering entire container to patient, rinse container with water and give residue to patient to ensure entire dose has been delivered.Under 1 year1 – 12 yearsAdults (over 12 years)Single Dose1 g/kg(5 mL/kg)25 – 50 g(120 – 240 mL)50 – 100 g(240 – 480 mL)Multiple Dose1 g/kg(5 mL/kg)every 4 – 6 hours25 – 50 g(120 – 240 mL)every 4 – 6 hours50 – 100 g(240 – 480 mL)every 4 – 6 hours•If previous attempts to contact a poison control center, emergency medical facility, or health professional were unsuccessful, continue trying. Keep patient active and moving. Save the container of poison.

Regulatory & Marketing

Labeler Name
Padagis Us Llc
Product Type
Human Otc Drug
FDA Application #
M023
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
11-10-2020
Listing Expiration
12-31-2027
Exclude Flag
N
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 (0574-0521). Click a package code to view its specific billing and regulatory data.

0574-0521-04
120 mL in 1 BOTTLE
0574-0521-08
240 mL in 1 BOTTLE
0574-0521-25
72 mL in 1 TUBE
0574-0521-74
120 mL in 1 TUBE

* 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 0574-0521-76 identifies a specific commercial package of 240 ml in 1 tube of Actidose Aqua, a human over the counter drug labeled by Padagis Us Llc. This product is billed per "ML" milliliter and contains an estimated amount of 240 billable units per package. This suspension is formulated for oral use and contains activated charcoal as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Padagis Us Llc on November 10, 2020. The current certification is valid through December 31, 2027.

How is this Padagis Us Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00574052176. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. There are 240 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)
0574-0521-76
11-Digit CMS (5-4-2)
00574-0521-76

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