Dometuss-g
NDC Package 53809-250-01

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

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

Dometuss-g is do not take more than 6 doses in any 24 hours period.AgeDoseadults and children 12 years of age and over1 tablets every 4 hours.children 6 to 12 years of age1/2 tablet every 4 hours.children under 6 years of ageConsult a doctor. Marketed by Domel, this product is identified by NDC 53809-250 and is authorized under FDA application M012.

Identification & Billing

NDC Package Code
53809-250-01
Package Description
100 TABLET in 1 BOTTLE
Product Code
53809-250
11-Digit Billing Format
53809025001
RxNorm Crosswalk
  • RxCUI: 2572023 - dextromethorphan HBr 20 MG / guaiFENesin 200 MG / phenylephrine HCl 10 MG Oral Tablet
  • RxCUI: 2572023 - dextromethorphan hydrobromide 20 MG / guaifenesin 200 MG / phenylephrine hydrochloride 10 MG Oral Tablet

Clinical Specifications

Proprietary Name
Dometuss-g
Dosage Form
-
Usage Information
Do not take more than 6 doses in any 24 hours period.AgeDoseadults and children 12 years of age and over1 tablets every 4 hours.children 6 to 12 years of age1/2 tablet every 4 hours.children under 6 years of ageConsult a doctor.

Regulatory & Marketing

Labeler Name
Domel
FDA Application #
M012
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
11-11-2019
Listing Expiration
12-31-2025
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (53809-250). Click a package code to view its specific billing and regulatory data.

53809-250-04
4 TABLET 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 53809-250-01 identifies a specific commercial package of 100 tablet in 1 bottle of Dometuss-g, labeled by Domel. 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 Domel on November 11, 2019. The current certification is valid through December 31, 2025.

How is this Domel product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 53809025001. 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)
53809-250-01
11-Digit CMS (5-4-2)
53809-0250-01

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