Visine Red Eye Hydrating Comfort Eye Drops
NDC Package 52904-968-03

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

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Visine Red Eye Hydrating Comfort Eye Drops is adults and children 6 years of age and over: put 1 or 2 drops in the affected eye(s) up to 4 times a daychildren under 6 years of age: consult a doctorchildren under 2 years of age: do not use. Marketed by Select Corporation, this product is identified by NDC 52904-968 and is authorized under FDA application part349.

Identification & Billing

NDC Package Code
52904-968-03
Package Description
1 BOTTLE, DROPPER in 1 BLISTER PACK / 8 mL in 1 BOTTLE, DROPPER
Product Code
52904-968
11-Digit Billing Format
52904096803
RxNorm Crosswalk
  • RxCUI: 996209 - polyethylene glycol 400 1 % / tetrahydrozoline HCl 0.05 % Ophthalmic Solution
  • RxCUI: 996209 - polyethylene glycol 400 10 MG/ML / tetrahydrozoline hydrochloride 0.5 MG/ML Ophthalmic Solution
  • RxCUI: 996209 - PEG 400 1 % / tetrahydrozoline hydrochloride 0.05 % Ophthalmic Solution

Clinical Specifications

Proprietary Name
Visine Red Eye Hydrating Comfort Eye Drops
Dosage Form
-
Usage Information
Adults and children 6 years of age and over: put 1 or 2 drops in the affected eye(s) up to 4 times a daychildren under 6 years of age: consult a doctorchildren under 2 years of age: do not use

Regulatory & Marketing

Labeler Name
Select Corporation
FDA Application #
part349
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
04-27-2020
Listing Expiration
12-31-2023
Exclude Flag
I
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 52904-968-03 identifies a specific commercial package of 1 bottle, dropper in 1 blister pack / 8 ml in 1 bottle, dropper of Visine Red Eye Hydrating Comfort Eye Drops, labeled by Select Corporation. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Select Corporation on April 27, 2020. The current certification is valid through December 31, 2023.

How is this Select Corporation product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 52904096803. 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)
52904-968-03
11-Digit CMS (5-4-2)
52904-0968-03

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