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  5. NDC Package Code: 55739-1022-3 Perineze Triple Dye

NDC Package 55739-1022-3 Perineze Triple Dye

View Billable Units, 11-Digit Format, RxNorm

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.

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:
55739-1022-3
Package Description:
250 AMPULE in 1 BOX / .61 mL in 1 AMPULE
Product Code:
55739-1022
Proprietary Name:
Perineze Triple Dye
Usage Information:
None
11-Digit NDC Billing Format:
55739102203
NDC to RxNorm Crosswalk:
  • RxCUI: 1188515 - brilliant green 2.29 MG / proflavine 1.14 MG / gentian violet 2.29 MG per 0.61 ML Topical Solution
  • RxCUI: 1188515 - brilliant green 3.75 MG/ML / gentian violet 3.75 MG/ML / proflavine 1.87 MG/ML Topical Solution
  • RxCUI: 1188520 - Perineze Triple Dye 2.29 MG / 1.14 MG / 2.29 MG per 0.61 ML Topical Solution
  • RxCUI: 1188520 - brilliant green 3.75 MG/ML / gentian violet 3.75 MG/ML / proflavine 1.87 MG/ML Topical Solution [Perineze Triple Dye]
  • RxCUI: 1188520 - Perineze Triple Dye (brilliant green 3.75 MG/ML / gentian violet 3.75 MG/ML / proflavine 1.87 MG/ML) Topical Solution
    • Labeler Name:
    Peace Medical Inc.
    Sample Package:
    No
    Start Marketing Date:
    09-28-2011
    Listing Expiration Date:
    12-31-2017
    Exclude Flag:
    I
    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.

    Frequently Asked Questions

    What is NDC 55739-1022-3?

    The NDC Packaged Code 55739-1022-3 is assigned to a package of 250 ampule in 1 box / .61 ml in 1 ampule of Perineze Triple Dye, labeled by Peace Medical Inc.. The product's dosage form is and is administered via form.

    Is NDC 55739-1022 included in the NDC Directory?

    No, Perineze Triple Dye with product code 55739-1022 is excluded from the NDC Directory because it's listing has been INACTIVATED by FDA. The product was first marketed by Peace Medical Inc. on September 28, 2011 and its listing in the NDC Directory is set to expire on December 31, 2017 if the product is not updated or renewed by the manufacturer.

    What is the 11-digit format for NDC 55739-1022-3?

    The 11-digit format is 55739102203. 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 5-4-1 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
    5-4-155739-1022-35-4-255739-1022-03