Raloxifene Hydrochloride Tablet, Film Coated
NDC Package 0904-6902-04

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

Package Information

Raloxifene Hydrochloride tablets is uSP is indicated for the treatment and prevention of osteoporosis in postmenopausal women [see Clinical Studies (14.1, 14.2)]. This formulation utilizes a tablet, film coated delivery system. Marketed by Major Pharmaceuticals, this product is identified by NDC 0904-6902 and is authorized under FDA application ANDA206384.

Identification & Billing

NDC Package Code
0904-6902-04
Package Description
30 BLISTER PACK in 1 CARTON / 1 TABLET, FILM COATED in 1 BLISTER PACK
Product Code
0904-6902
11-Digit Billing Format
00904690204
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
30 EA
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Raloxifene Hydrochloride
Non-Proprietary Name
Raloxifene Hydrochloride
Substance Name
Raloxifene Hydrochloride
Dosage Form
Tablet, Film Coated - A solid dosage form that contains medicinal substances with or without suitable diluents and is coated with a thin layer of a water-insoluble or water-soluble polymer.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
RALOXIFENE HYDROCHLORIDE 60 mg/1
Pharmacologic Class
Usage Information
Raloxifene hydrochloride tablets, USP is indicated for the treatment and prevention of osteoporosis in postmenopausal women [see Clinical Studies (14.1, 14.2)].

Regulatory & Marketing

Labeler Name
Major Pharmaceuticals
Product Type
Human Prescription Drug
FDA Application #
ANDA206384
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
10-12-2016
Listing Expiration
12-31-2026
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 0904-6902-04 identifies a specific commercial package of 30 blister pack in 1 carton / 1 tablet, film coated in 1 blister pack of Raloxifene Hydrochloride, a human prescription drug labeled by Major Pharmaceuticals. This tablet, film coated is formulated for oral use and contains raloxifene 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 Major Pharmaceuticals on October 12, 2016. The current certification is valid through December 31, 2026.

How is this Major Pharmaceuticals product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00904690204. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 30 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)
0904-6902-04
11-Digit CMS (5-4-2)
00904-6902-04

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