Triple
NDC Package 11086-040-01

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 inactivated by the FDA.

Triple is usesFor the treatment of superficial skin infections caused by yeast (Candida albicans).Relieves discomfort, irritation, redness and chafing associated with jock itchCures most jock itch (tinea cruris). Marketed by Summers Laboratories Inc, this product is identified by NDC 11086-040 and is authorized under FDA application M005.

Identification & Billing

NDC Package Code
11086-040-01
Package Description
28.7 g in 1 TUBE
Product Code
11086-040
11-Digit Billing Format
11086004001
Billing Unit
GM - Billing unit of "gram" is used when a product is measured by its weight.
Units Per Package
28.7 GM
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Triple AF
Dosage Form
-
Usage Information
UsesFor the treatment of superficial skin infections caused by yeast (Candida albicans).Relieves discomfort, irritation, redness and chafing associated with jock itchCures most jock itch (tinea cruris)

Regulatory & Marketing

Labeler Name
Summers Laboratories Inc
FDA Application #
M005
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
10-30-2013
Listing Expiration
12-31-2024
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (11086-040). Click a package code to view its specific billing and regulatory data.

11086-040-02
57 g 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 11086-040-01 identifies a specific commercial package of 28.7 g in 1 tube of Triple AF, labeled by Summers Laboratories Inc. This product is billed per "GM" gram and contains an estimated amount of 28.7 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 Summers Laboratories Inc on October 30, 2013. The current certification is valid through December 31, 2024.

How is this Summers Laboratories Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 11086004001. Quantities are measured in per "gm or gram", products billed per gram are products measured by weight.. There are 28.7 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 (5-3-2)
11086-040-01
11-Digit CMS (5-4-2)
11086-0040-01

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