Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate And Scopolamine Hydrobromide Tablet
NDC Package 50742-667-01

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

Package Information

Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate And Scopolamine Hydrobromide tablets is glaucoma;obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy);obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.);paralytic ileus, intestinal atony of the elderly or debilitated patient;unstable cardiovascular status in acute hemorrhage;severe ulcerative colitis especially if complicated by toxic megacolon;myasthenia gravis;hiatal hernia associated with reflux esophagitis;in patients with known hypersensitivity to any of the ingredients.Phenobarbital is contraindicated in acute intermittent porphyria and in those patients in whom phenobarbital produces restlessness and/or excitement. This formulation utilizes a tablet delivery system. Marketed by Ingenus Pharmaceuticals, Llc, this product is identified by NDC 50742-667.

Identification & Billing

NDC Package Code
50742-667-01
Package Description
100 TABLET in 1 BOTTLE, PLASTIC
Product Code
50742-667
11-Digit Billing Format
50742066701
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
100 EA
RxNorm Crosswalk
  • RxCUI: 1046815 - atropine sulfate 0.0194 MG / hyoscyamine sulfate 0.1037 MG / PHENobarbital 16.2 MG / scopolamine HBr 0.0065 MG Oral Tablet
  • RxCUI: 1046815 - atropine sulfate 0.0194 MG / hyoscyamine sulfate 0.1037 MG / phenobarbital 16.2 MG / scopolamine hydrobromide 0.0065 MG Oral Tablet

Clinical Specifications

Proprietary Name
Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate And Scopolamine Hydrobromide
Non-Proprietary Name
Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate And Scopolamine Hydrobromide
Substance Name
Atropine Sulfate; Hyoscyamine Sulfate; Phenobarbital; Scopolamine Hydrobromide
Dosage Form
Tablet - A solid dosage form containing medicinal substances with or without suitable diluents.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
Glaucoma;obstructive uropathy (for example, bladder neck obstruction due to prostatic hypertrophy);obstructive disease of the gastrointestinal tract (as in achalasia, pyloroduodenal stenosis, etc.);paralytic ileus, intestinal atony of the elderly or debilitated patient;unstable cardiovascular status in acute hemorrhage;severe ulcerative colitis especially if complicated by toxic megacolon;myasthenia gravis;hiatal hernia associated with reflux esophagitis;in patients with known hypersensitivity to any of the ingredients.Phenobarbital is contraindicated in acute intermittent porphyria and in those patients in whom phenobarbital produces restlessness and/or excitement.
DEA Schedule
Schedule IV (CIV) Substances

Regulatory & Marketing

Labeler Name
Ingenus Pharmaceuticals, Llc
Product Type
Human Prescription Drug
Marketing Category
UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
Start Marketing Date
08-01-2021
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 50742-667-01 identifies a specific commercial package of 100 tablet in 1 bottle, plastic of Phenobarbital, Hyoscyamine Sulfate, Atropine Sulfate And Scopolamine Hydrobromide, a human prescription drug labeled by Ingenus Pharmaceuticals, Llc. This product is billed for "EA" each discreet unit and contains an estimated amount of 100 billable units per package. This tablet is formulated for oral use and contains atropine sulfate; hyoscyamine sulfate; phenobarbital; scopolamine hydrobromide 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 August 01, 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: 50742066701. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 100 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 (5-3-2)
50742-667-01
11-Digit CMS (5-4-2)
50742-0667-01

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