Dicyclomine Hydrochloride Tablet
NDC Package 0615-8622-39

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

Package Information

Dicyclomine Hydrochloride tablets is dicyclomine hydrochloride tablets are indicated for the treatment of patients with functional bowel/irritable bowel syndrome. This formulation utilizes a tablet delivery system. Marketed by Ncs Healthcare Of Ky, Llc Dba Vangard Labs, this product is identified by NDC 0615-8622 and is authorized under FDA application ANDA216736.

Identification & Billing

NDC Package Code
0615-8622-39
Package Description
30 TABLET in 1 BLISTER PACK
Product Code
0615-8622
11-Digit Billing Format
00615862239
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Dicyclomine Hydrochloride
Non-Proprietary Name
Dicyclomine Hydrochloride
Substance Name
Dicyclomine Hydrochloride
Dosage Form
Tablet - A solid dosage form containing medicinal substances with or without suitable diluents.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
DICYCLOMINE HYDROCHLORIDE 20 mg/1
Pharmacologic Class
Usage Information
Dicyclomine hydrochloride tablets are indicated for the treatment of patients with functional bowel/irritable bowel syndrome.

Regulatory & Marketing

Labeler Name
Ncs Healthcare Of Ky, Llc Dba Vangard Labs
Product Type
Human Prescription Drug
FDA Application #
ANDA216736
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
12-14-2022
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 0615-8622-39 identifies a specific commercial package of 30 tablet in 1 blister pack of Dicyclomine Hydrochloride, a human prescription drug labeled by Ncs Healthcare Of Ky, Llc Dba Vangard Labs. This tablet is formulated for oral use and contains dicyclomine hydrochloride 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 Ncs Healthcare Of Ky, Llc Dba Vangard Labs on December 14, 2022. The current certification is valid through December 31, 2027.

How is this Ncs Healthcare Of Ky, Llc Dba Vangard Labs product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00615862239. 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)
0615-8622-39
11-Digit CMS (5-4-2)
00615-8622-39

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