Polyvinyl Alcohol Solution/ Drops
NDC Package 50090-7119-0

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

Package Information

Polyvinyl Alcohol solution/ dropses is a medication used to relieve dry, irritated eyes. This formulation utilizes a solution/ drops delivery system. Marketed by A-s Medication Solutions, this product is identified by NDC 50090-7119 and is authorized under FDA application M018.

Identification & Billing

NDC Package Code
50090-7119-0
Package Description
15 mL in 1 BOTTLE
Product Code
50090-7119
11-Digit Billing Format
50090711900
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
Units Per Package
15 ML
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Polyvinyl Alcohol
Non-Proprietary Name
Polyvinyl Alcohol
Substance Name
Polyvinyl Alcohol
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)
POLYVINYL ALCOHOL 14 mg/mL
Usage Information
This medication is used to relieve dry, irritated eyes. Common causes for dry eyes include wind, sun, heating/air conditioning, computer use/reading, and certain medications. This product may contain 1 or more of the following ingredients: carboxymethylcellulose, dextran, glycerin, hypromellose, polyethylene glycol 400 (PEG 400), polysorbate, polyvinyl alcohol, povidone, or propylene glycol, among others. Eye lubricants keep the eye moist, help to protect the eye from injury and infection, and decrease symptoms of dry eyes such as burning, itching, and feeling as if something is in the eye.

Regulatory & Marketing

Labeler Name
A-s Medication Solutions
Product Type
Human Otc Drug
FDA Application #
M018
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
01-05-2023
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 50090-7119-0 identifies a specific commercial package of 15 ml in 1 bottle of Polyvinyl Alcohol, a human over the counter drug labeled by A-s Medication Solutions. This product is billed per "ML" milliliter and contains an estimated amount of 15 billable units per package. This solution/ drops is formulated for ophthalmic use and contains polyvinyl alcohol 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 A-s Medication Solutions on January 05, 2023. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This medication is used to relieve dry, irritated eyes. Common causes for dry eyes include wind, sun, heating/air conditioning, computer use/reading, and certain medications. This product may contain 1 or more of the following ingredients: carboxymethylcellulose, dextran, glycerin, hypromellose, polyethylene glycol 400 (PEG 400), polysorbate, polyvinyl alcohol, povidone, or propylene glycol, among others. Eye lubricants keep the eye moist, help to protect the eye from injury and infection, and decrease symptoms of dry eyes such as burning, itching, and feeling as if something is in the eye.

How is this A-s Medication Solutions product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 50090711900. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. There are 15 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 (5-4-1)
50090-7119-0
11-Digit CMS (5-4-2)
50090-7119-00

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