Sodium Tetradecyl Sulfate Injection, Solution
NDC Package 24201-201-05

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

Package Information

Sodium Tetradecyl Sulfate injection is indicated in the treatment of small uncomplicated varicose veins of the lower extremities that show simple dilation with competent valves. This formulation utilizes a injection, solution delivery system. Marketed by Hikma Pharmaceuticals Usa Inc., this product is identified by NDC 24201-201 and is authorized under FDA application ANDA209937.

Identification & Billing

NDC Package Code
24201-201-05
Package Description
5 VIAL, GLASS in 1 CARTON / 2 mL in 1 VIAL, GLASS (24201-201-01)
Product Code
24201-201
11-Digit Billing Format
24201020105
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
RxNorm Crosswalk
  • RxCUI: 204491 - sodium tetradecyl sulfate 3 % Injectable Solution
  • RxCUI: 204491 - sodium tetradecyl sulfate 30 MG/ML Injectable Solution

Clinical Specifications

Proprietary Name
Sodium Tetradecyl Sulfate
Non-Proprietary Name
Sodium Tetradecyl Sulfate
Substance Name
Sodium Tetradecyl Sulfate
Dosage Form
Injection, Solution - A liquid preparation containing one or more drug substances dissolved in a suitable solvent or mixture of mutually miscible solvents that is suitable for injection.
Administration Route
Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
SODIUM TETRADECYL SULFATE 30 mg/mL
Usage Information
Sodium tetradecyl sulfate injection is indicated in the treatment of small uncomplicated varicose veins of the lower extremities that show simple dilation with competent valves. The benefit- to-risk ratio should be considered in selected patients who are great surgical risks.

Regulatory & Marketing

Labeler Name
Hikma Pharmaceuticals Usa Inc.
Product Type
Human Prescription Drug
FDA Application #
ANDA209937
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
12-09-2019
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 24201-201-05 identifies a specific commercial package of 5 vial, glass in 1 carton / 2 ml in 1 vial, glass (24201-201-01) of Sodium Tetradecyl Sulfate, a human prescription drug labeled by Hikma Pharmaceuticals Usa Inc.. This injection, solution is formulated for intravenous use and contains sodium tetradecyl sulfate 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 Hikma Pharmaceuticals Usa Inc. on December 09, 2019. The current certification is valid through December 31, 2026.

How is this Hikma Pharmaceuticals Usa Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 24201020105. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. 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)
24201-201-05
11-Digit CMS (5-4-2)
24201-0201-05

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