Triple Antibiotic Grx
NDC Package 54162-080-09

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.

Triple Antibiotic Grx is clean the affected areaapply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times dailymay be covered with a sterile bandage. Marketed by Geritrex Llc, this product is identified by NDC 54162-080 and is authorized under FDA application part333B.

Identification & Billing

NDC Package Code
54162-080-09
Package Description
.9 g in 1 POUCH
Product Code
54162-080
11-Digit Billing Format
54162008009
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
1 EA
RxNorm Crosswalk
  • RxCUI: 204602 - bacitracin 400 UNT / neomycin 3.5 MG / polymyxin B 5000 UNT per GM Topical Ointment
  • RxCUI: 204602 - bacitracin 0.4 UNT/MG / neomycin 0.0035 MG/MG / polymyxin B 5 UNT/MG Topical Ointment
  • RxCUI: 204602 - bacitracin 400 UNT / neomycin 3.5 MG (as neomycin sulfate 5 MG) / polymyxin B 5000 UNT per GM Topical Ointment

Clinical Specifications

Proprietary Name
Triple Antibiotic Grx
Dosage Form
-
Usage Information
Clean the affected areaapply a small amount of this product (an amount equal to the surface area of the tip of a finger) on the area 1 to 3 times dailymay be covered with a sterile bandage

Regulatory & Marketing

Labeler Name
Geritrex Llc
FDA Application #
part333B
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
12-01-2017
Listing Expiration
12-31-2019
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 54162-080-09 identifies a specific commercial package of .9 g in 1 pouch of Triple Antibiotic Grx, labeled by Geritrex Llc. This product is billed for "EA" each discreet unit and contains an estimated amount of 1 billable units per package. 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 Geritrex Llc on December 01, 2017. The current certification is valid through December 31, 2019.

How is this Geritrex Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 54162008009. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 1 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)
54162-080-09
11-Digit CMS (5-4-2)
54162-0080-09

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