Alahist Dm Liquid
NDC Package 50991-444-15

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

Package Information

Alahist Dm (dextromethorphan hbr, pheniramine maleate, phenylephrine hcl) liquids is do not exceed recommended dosage.Adults and children 12 years of age and over: 2 teaspoonful (10 mL) every 4 to 6 hours, not to exceed 12 teaspoonfuls in a 24 hours Children 6 to under 12 years of age: 1 teaspoonful (5 mL) every 4 to 6 hours, not to exceed 6 teaspoonfuls in 24 hours Children under 6 years of age: Consult a doctor. This formulation utilizes a liquid delivery system. Marketed by Poly Pharmaceuticals, Inc., this product is identified by NDC 50991-444 and is authorized under FDA application M012.

Identification & Billing

NDC Package Code
50991-444-15
Package Description
15 mL in 1 BOTTLE
Product Code
50991-444
11-Digit Billing Format
50991044415
RxNorm Crosswalk
  • RxCUI: 2639752 - dextromethorphan HBr 10 MG / pheniramine maleate 12.5 MG / phenylephrine HCl 5 MG in 5 mL Oral Solution
  • RxCUI: 2639752 - dextromethorphan hydrobromide 2 MG/ML / pheniramine maleate 2.5 MG/ML / phenylephrine hydrochloride 1 MG/ML Oral Solution
  • RxCUI: 2639752 - dextromethorphan hydrobromide 10 MG / pheniramine maleate 12.5 MG / phenylephrine hydrochloride 5 MG per 5 ML Oral Solution

Clinical Specifications

Proprietary Name
Alahist Dm
Non-Proprietary Name
Dextromethorphan Hbr, Pheniramine Maleate, Phenylephrine Hcl
Substance Name
Dextromethorphan Hydrobromide; Pheniramine Maleate; Phenylephrine Hydrochloride
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
Do not exceed recommended dosage.Adults and children 12 years of age and over: 2 teaspoonful (10 mL) every 4 to 6 hours, not to exceed 12 teaspoonfuls in a 24 hours Children 6 to under 12 years of age: 1 teaspoonful (5 mL) every 4 to 6 hours, not to exceed 6 teaspoonfuls in 24 hours Children under 6 years of age: Consult a doctor.

Regulatory & Marketing

Labeler Name
Poly Pharmaceuticals, Inc.
Product Type
Human Otc Drug
FDA Application #
M012
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
06-08-2023
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (50991-444). Click a package code to view its specific billing and regulatory data.

50991-444-16
473 mL in 1 BOTTLE

* 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 50991-444-15 identifies a specific commercial package of 15 ml in 1 bottle of Alahist Dm, a human over the counter drug labeled by Poly Pharmaceuticals, Inc.. This liquid is formulated for oral use and contains dextromethorphan hydrobromide; pheniramine maleate; phenylephrine hydrochloride 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 Poly Pharmaceuticals, Inc. on June 08, 2023. The current certification is valid through December 31, 2026.

How is this Poly Pharmaceuticals, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 50991044415. 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)
50991-444-15
11-Digit CMS (5-4-2)
50991-0444-15

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