Visco Shield Solution/ Drops
NDC Package 42126-5200-0

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

Package Information

Visco Shield (hypromellose 2208 (15000 mpa.s)) solution/ dropses is remove cap from syringe and screw on applicator tipInstill 1 or 2 drops in the affected eye(s) as needed. This formulation utilizes a solution/ drops delivery system. Marketed by Oasis Medical, Inc., this product is identified by NDC 42126-5200 and is authorized under FDA application M018.

Identification & Billing

NDC Package Code
42126-5200-0
Package Description
6 POUCH in 1 CARTON / 1 SYRINGE, PLASTIC in 1 POUCH / 2 mL in 1 SYRINGE, PLASTIC
Product Code
42126-5200
11-Digit Billing Format
42126520000
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Visco Shield Lubricant
Non-Proprietary Name
Hypromellose 2208 (15000 Mpa.s)
Substance Name
Hypromellose 2208 (15000 Mpa.s)
Dosage Form
Solution/ Drops - A solution which is usually administered in a drop-wise fashion.
Administration Route
Ophthalmic - Administration to the external eye.
Active Ingredient(s)
HYPROMELLOSE 2208 (15000 MPA.S) 17 mg/mL
Usage Information
Remove cap from syringe and screw on applicator tipInstill 1 or 2 drops in the affected eye(s) as needed.

Regulatory & Marketing

Labeler Name
Oasis Medical, Inc.
Product Type
Human Otc Drug
FDA Application #
M018
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
06-16-2014
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 42126-5200-0 identifies a specific commercial package of 6 pouch in 1 carton / 1 syringe, plastic in 1 pouch / 2 ml in 1 syringe, plastic of Visco Shield Lubricant, a human over the counter drug labeled by Oasis Medical, Inc.. This solution/ drops is formulated for ophthalmic use and contains hypromellose 2208 (15000 mpa.s) 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 Oasis Medical, Inc. on June 16, 2014. The current certification is valid through December 31, 2026.

How is this Oasis Medical, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 42126520000. 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)
42126-5200-0
11-Digit CMS (5-4-2)
42126-5200-00

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