Ibuprofen, Diphenhydramine Hcl Capsule, Liquid Filled
NDC Package 11822-0789-4

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

Package Information

Ibuprofen, Diphenhydramine Hcl capsules is ■ do not take more than directed■ adults and children 12 years and over: take 2 capsules at bedtime■ do not take more than 2 capsules in 24 hours. This formulation utilizes a capsule, liquid filled delivery system. Marketed by Rite Aid Corporation, this product is identified by NDC 11822-0789 and is authorized under FDA application ANDA090397.

Identification & Billing

NDC Package Code
11822-0789-4
Package Description
1 BOTTLE in 1 CARTON / 40 CAPSULE, LIQUID FILLED in 1 BOTTLE
Product Code
11822-0789
11-Digit Billing Format
11822078904
RxNorm Crosswalk
  • RxCUI: 901814 - ibuprofen 200 MG / diphenhydrAMINE HCl 25 MG Oral Capsule
  • RxCUI: 901814 - diphenhydramine hydrochloride 25 MG / ibuprofen 200 MG Oral Capsule

Clinical Specifications

Proprietary Name
Ibuprofen, Diphenhydramine Hcl
Non-Proprietary Name
Ibuprofen, Diphenhydramine Hcl
Substance Name
Diphenhydramine Hydrochloride; Ibuprofen
Dosage Form
Capsule, Liquid Filled - A solid dosage form in which the drug is enclosed within a soluble, gelatin shell which is plasticized by the addition of a polyol, such as sorbitol or glycerin, and is therefore of a somewhat thicker consistency than that of a hard shell capsule; typically, the active ingredients are dissolved or suspended in a liquid vehicle.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
■ do not take more than directed■ adults and children 12 years and over: take 2 capsules at bedtime■ do not take more than 2 capsules in 24 hours

Regulatory & Marketing

Labeler Name
Rite Aid Corporation
Product Type
Human Otc Drug
FDA Application #
ANDA090397
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
04-15-2020
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 11822-0789-4 identifies a specific commercial package of 1 bottle in 1 carton / 40 capsule, liquid filled in 1 bottle of Ibuprofen, Diphenhydramine Hcl, a human over the counter drug labeled by Rite Aid Corporation. This capsule, liquid filled is formulated for oral use and contains diphenhydramine hydrochloride; ibuprofen 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 Rite Aid Corporation on April 15, 2020. The current certification is valid through December 31, 2026.

How is this Rite Aid Corporation product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 11822078904. 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 (5-4-1)
11822-0789-4
11-Digit CMS (5-4-2)
11822-0789-04

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