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  5. NDC Package Code: 50991-626-01 Poly Hist Forte

NDC Package 50991-626-01 Poly Hist Forte

Doxylamine Succinate And Phenylephrine Hydrochloride Tablet Oral - View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Find all the important details about this NDC Package code, including the 11-Digit NDC Billing number, billing units, wholesale price, RxNorm crosswalk, active ingredients, pharmacologic clasess, etc.

NDC Package Code:
50991-626-01
Package Description:
100 TABLET in 1 BOTTLE
Product Code:
50991-626
Proprietary Name:
Poly Hist Forte
Non-Proprietary Name:
Doxylamine Succinate And Phenylephrine Hydrochloride
Substance Name:
Doxylamine Succinate; Phenylephrine Hydrochloride
Usage Information:
Do not exceed recommended dosage. Adults and children 12 years of age and over 1 tablet every 4 hours, not to exceed 6 tablets in 24 hours.  Children 6 to 12 years of age:  1/2 tablet every 4 hours, not to exceed 3 tablets in 24 hours.  Children 6 years       of age and younger:        Consult a physician.
11-Digit NDC Billing Format:
50991062601
Billing Unit:
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
NDC to RxNorm Crosswalk:
100 EA
NDC to RxNorm Crosswalk:
  • RxCUI: 2172491 - doxylamine succinate 10.5 MG / phenylephrine HCl 10 MG Oral Tablet
  • RxCUI: 2172491 - doxylamine succinate 10.5 MG / phenylephrine hydrochloride 10 MG Oral Tablet
    • Product Type:
    Human Otc Drug
    Labeler Name:
    Poly Pharmaceuticals, Inc.
    Dosage Form:
    Tablet - A solid dosage form containing medicinal substances with or without suitable diluents.
    Administration Route(s):
  • Oral - Administration to or by way of the mouth.
    • Active Ingredient(s):
  • DOXYLAMINE SUCCINATE 10.5 mg/1
  • PHENYLEPHRINE HYDROCHLORIDE 10 mg/1
    • Pharmacologic Class(es):
  • Adrenergic alpha1-Agonists - [MoA] (Mechanism of Action)
  • Antihistamine - [EPC] (Established Pharmacologic Class)
  • Histamine Receptor Antagonists - [MoA] (Mechanism of Action)
  • alpha-1 Adrenergic Agonist - [EPC] (Established Pharmacologic Class)
    • Sample Package:
    No
    Marketing Category:
    UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
    Start Marketing Date:
    06-01-2019
    Listing Expiration Date:
    12-31-2025
    Exclude Flag:
    N
    Code Structure:

    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 disclaimer below.

    Other Product Packages

    The following packages are also available for this product:

    NDC Package CodePackage Description
    50991-626-0212 BLISTER PACK in 1 CARTON / 1 TABLET in 1 BLISTER PACK

    * Please review the disclaimer below.

    Frequently Asked Questions

    What is NDC 50991-626-01?

    The NDC Packaged Code 50991-626-01 is assigned to a package of 100 tablet in 1 bottle of Poly Hist Forte, a human over the counter drug labeled by Poly Pharmaceuticals, Inc.. The product's dosage form is tablet and is administered via oral form.

    Is NDC 50991-626 included in the NDC Directory?

    Yes, Poly Hist Forte with product code 50991-626 is active and included in the NDC Directory. The product was first marketed by Poly Pharmaceuticals, Inc. on June 01, 2019 and its listing in the NDC Directory is set to expire on December 31, 2025 if the product is not updated or renewed by the manufacturer.

    What is the NDC billing unit for package 50991-626-01?

    The contents of this package are billed per "each", products billed on a per each basis are usually products dispensed in discreet units. The calculated billable units for this package is 100.

    What is the 11-digit format for NDC 50991-626-01?

    The 11-digit format is 50991062601. The 11-digit billing format might be required by the Centers for Medicare & Medicaid Services (CMS) and other payers in billing claim forms.

    This package code is originally configured in a 5-3-2 segment 10-digit format and by adding a zero within the original NDC package code we can obtain the converted 11-digit format in a 5-4-2 segment configuration. The table below shows the 11-digit code conversion:

    10-Digit Format10-Digit Original Code11-Digit Format11-Digit Code
    5-3-250991-626-015-4-250991-0626-01