Ultracet
NDC Package 21695-143-72

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

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Ultracet is see also Warning section. Marketed by Rebel Distributors Corp, this product is identified by NDC 21695-143 and is authorized under FDA application NDA021123.

Identification & Billing

NDC Package Code
21695-143-72
Package Description
120 TABLET in 1 BOTTLE
Product Code
21695-143
11-Digit Billing Format
21695014372
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
120 EA
RxNorm Crosswalk
  • RxCUI: 836395 - traMADol HCl 37.5 MG / acetaminophen 325 MG Oral Tablet
  • RxCUI: 836395 - acetaminophen 325 MG / tramadol hydrochloride 37.5 MG Oral Tablet
  • RxCUI: 836395 - APAP 325 MG / tramadol hydrochloride 37.5 MG Oral Tablet
  • RxCUI: 836397 - ULTRACET 37.5 MG / 325 MG Oral Tablet
  • RxCUI: 836397 - acetaminophen 325 MG / tramadol hydrochloride 37.5 MG Oral Tablet [Ultracet]

Clinical Specifications

Proprietary Name
Ultracet
Dosage Form
-
Usage Information
See also Warning section. This product is used to treat moderate to moderately severe pain. It contains 2 medications: tramadol and acetaminophen. Tramadol is similar to opioid analgesics. It works in the brain to change how your body feels and responds to pain. Acetaminophen is used to relieve pain, and it can also reduce a fever.

Regulatory & Marketing

Labeler Name
Rebel Distributors Corp
FDA Application #
NDA021123
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
08-15-2001
Listing Expiration
12-31-2017
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 21695-143-72 identifies a specific commercial package of 120 tablet in 1 bottle of Ultracet, labeled by Rebel Distributors Corp. This product is billed for "EA" each discreet unit and contains an estimated amount of 120 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 Rebel Distributors Corp on August 15, 2001. The current certification is valid through December 31, 2017.

What are the primary indications for this medication?

See also Warning section. This product is used to treat moderate to moderately severe pain. It contains 2 medications: tramadol and acetaminophen. Tramadol is similar to opioid analgesics. It works in the brain to change how your body feels and responds to pain. Acetaminophen is used to relieve pain, and it can also reduce a fever.

How is this Rebel Distributors Corp product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 21695014372. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 120 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)
21695-143-72
11-Digit CMS (5-4-2)
21695-0143-72

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