Dolishale Tablet
NDC Package 50742-659-84
Package Information
Dolishale (levonorgestrel and ethinyl estradiol) tablets is dOLISHALE is indicated for the prevention of pregnancy in women who elect to use oral contraceptives as a method of contraception. This formulation utilizes a tablet delivery system. Marketed by Ingenus Pharmaceuticals, Llc, this product is identified by NDC 50742-659 and is authorized under FDA application ANDA091692.
Identification & Billing
- RxCUI: 2472307 - {28 (ethinyl estradiol 0.02 MG / levonorgestrel 0.09 MG Oral Tablet) } Pack [Dolishale 28 Day]
- RxCUI: 2472307 - Dolishale 28 Day Pack
- RxCUI: 722152 - ethinyl estradiol 20 MCG / levonorgestrel 90 MCG Oral Tablet
- RxCUI: 722152 - ethinyl estradiol 0.02 MG / levonorgestrel 0.09 MG Oral Tablet
- RxCUI: 751553 - {28 (ethinyl estradiol 0.02 MG / levonorgestrel 0.09 MG Oral Tablet) } Pack
Clinical Specifications
- Estrogen Receptor Agonists - [MoA] (Mechanism of Action)
- Estrogen - [EPC] (Established Pharmacologic Class)
- Inhibit Ovum Fertilization - [PE] (Physiologic Effect)
- Progesterone Congeners - [CS]
- Progestin - [EPC] (Established Pharmacologic Class)
- Progestin-containing Intrauterine System - [EPC] (Established Pharmacologic Class)
Regulatory & Marketing
Hierarchy Structure
- 50742 - Ingenus Pharmaceuticals, Llc
- 50742-659 - Dolishale
- 50742-659-84 - 3 BLISTER PACK in 1 CARTON / 28 TABLET in 1 BLISTER PACK
- 50742-659 - Dolishale
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.
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Other Available Packages
The following commercial packages are registered under the same Product NDC (50742-659). Click a package code to view its specific billing and regulatory data.
* 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 50742-659-84 identifies a specific commercial package of 3 blister pack in 1 carton / 28 tablet in 1 blister pack of Dolishale, a human prescription drug labeled by Ingenus Pharmaceuticals, Llc. This tablet is formulated for oral use and contains ethinyl estradiol; levonorgestrel 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 Ingenus Pharmaceuticals, Llc on January 03, 2021. The current certification is valid through December 31, 2026.
How is this Ingenus Pharmaceuticals, Llc product billed for insurance claims?
For medical billing and reimbursement, this package follows the 11-digit CMS format: 50742065984. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 3 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:
Note: The zero is added to the Product segment to maintain the 5-4-2 structure.