Poli-a Ointment
NDC Package 49873-703-01

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

Package Information

Poli-a (hydrocortisone acetate) ointment is a medication used to treat hemorrhoids and itching/swelling in the rectum and anus. This formulation utilizes a ointment delivery system. Marketed by Sato Pharmaceutical Co., Ltd., this product is identified by NDC 49873-703 and is authorized under FDA application M017.

Identification & Billing

NDC Package Code
49873-703-01
Package Description
1 TUBE in 1 CARTON / 20 g in 1 TUBE
Product Code
49873-703
11-Digit Billing Format
49873070301
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Poli-a
Non-Proprietary Name
Hydrocortisone Acetate
Substance Name
Hydrocortisone Acetate
Dosage Form
Ointment - A semisolid3 dosage form, usually containing <20% water and volatiles5 and >50% hydrocarbons, waxes, or polyols as the vehicle. This dosage form is generally for external application to the skin or mucous membranes.
Administration Route
Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
Active Ingredient(s)
HYDROCORTISONE ACETATE 1 g/100g
Pharmacologic Class
Usage Information
This medication is used to treat hemorrhoids and itching/swelling in the rectum and anus. It is also used with other medications to treat certain intestinal problems (such as ulcerative colitis of the rectum and other rectal/anal inflammatory conditions). Hydrocortisone suppositories help to relieve rectal pain, itching, bloody diarrhea, and bleeding by reducing swelling (inflammation) directly in the rectum and anus. Hydrocortisone belongs to a class of drugs called corticosteroids.

Regulatory & Marketing

Labeler Name
Sato Pharmaceutical Co., Ltd.
Product Type
Human Otc Drug
FDA Application #
M017
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-19-1995
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 49873-703-01 identifies a specific commercial package of 1 tube in 1 carton / 20 g in 1 tube of Poli-a, a human over the counter drug labeled by Sato Pharmaceutical Co., Ltd.. This ointment is formulated for topical use and contains hydrocortisone acetate 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 Sato Pharmaceutical Co., Ltd. on March 19, 1995. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This medication is used to treat hemorrhoids and itching/swelling in the rectum and anus. It is also used with other medications to treat certain intestinal problems (such as ulcerative colitis of the rectum and other rectal/anal inflammatory conditions). Hydrocortisone suppositories help to relieve rectal pain, itching, bloody diarrhea, and bleeding by reducing swelling (inflammation) directly in the rectum and anus. Hydrocortisone belongs to a class of drugs called corticosteroids.

How is this Sato Pharmaceutical Co., Ltd. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 49873070301. 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)
49873-703-01
11-Digit CMS (5-4-2)
49873-0703-01

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