Grain And Soy Allergen Mix Liquid
NDC Package 43742-1627-1

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

Package Information

Grain And Soy Allergen Mix (adenosinum triphosphoricum dinatrum, quercetin, rutin, natrum carbonicum, ileum (suis), jejunum (suis) stomach (suis), gluten, amaranth, avena sativa, natrum sulphuricum, sarcolacticum acidum, triticum repens, cortisone aceticum, glyphosate, sycotic co bacillus) liquids is for the temporary relief of symptoms related to consumption of grains, soy, and gluten, including bowel irregularity, occasional diarrhea, occasional constipation, and fatigue.****These statements are based upon homeopathic principles. This formulation utilizes a liquid delivery system. Marketed by Deseret Biologicals, Inc., this product is identified by NDC 43742-1627.

Identification & Billing

NDC Package Code
43742-1627-1
Package Description
30 mL in 1 BOTTLE, DROPPER
Product Code
43742-1627
11-Digit Billing Format
43742162701

Clinical Specifications

Proprietary Name
Grain And Soy Allergen Mix
Non-Proprietary Name
Adenosinum Triphosphoricum Dinatrum, Quercetin, Rutin, Natrum Carbonicum, Ileum (suis), Jejunum (suis) Stomach (suis), Gluten, Amaranth, Avena Sativa, Natrum Sulphuricum, Sarcolacticum Acidum, Triticum Repens, Cortisone Aceticum, Glyphosate, Sycotic Co Bacillus
Substance Name
Adenosine Triphosphate Disodium; Amaranth; Avena Sativa Flowering Top; Cortisone Acetate; Elymus Repens Root; Enterococcus Faecalis; Glyphosate; Lactic Acid, L-; Quercetin; Rutin; Sodium Carbonate; Sodium Sulfate; Sus Scrofa Ileum; Sus Scrofa Jejunum; Sus Scrofa Stomach; Wheat Gluten
Dosage Form
Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
For the temporary relief of symptoms related to consumption of grains, soy, and gluten, including bowel irregularity, occasional diarrhea, occasional constipation, and fatigue.****These statements are based upon homeopathic principles. They have not been reviewed by the Food and Drug Administration. For the temporary relief of symptoms related to consumption of grains, soy, and gluten, including bowel irregularity, occasional diarrhea, occasional constipation, and fatigue.****These statements are based upon homeopathic principles. They have not been reviewed by the Food and Drug Administration.

Regulatory & Marketing

Labeler Name
Deseret Biologicals, Inc.
Product Type
Human Otc Drug
Marketing Category
UNAPPROVED HOMEOPATHIC - A category specifying that a product is marketed as unapproved homeopathic product.
Start Marketing Date
03-12-2020
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 43742-1627-1 identifies a specific commercial package of 30 ml in 1 bottle, dropper of Grain And Soy Allergen Mix, a human over the counter drug labeled by Deseret Biologicals, Inc.. This liquid is formulated for oral use and contains adenosine triphosphate disodium; amaranth; avena sativa flowering top; cortisone acetate; elymus repens root; enterococcus faecalis; glyphosate; lactic acid, l-; quercetin; rutin; sodium carbonate; sodium sulfate; sus scrofa ileum; sus scrofa jejunum; sus scrofa stomach; wheat gluten 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 Deseret Biologicals, Inc. on March 12, 2020. The current certification is valid through December 31, 2026.

How is this Deseret Biologicals, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 43742162701. 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)
43742-1627-1
11-Digit CMS (5-4-2)
43742-1627-01

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