Rexall Sterile Artificial Tears Eye Drops
NDC Package 55910-522-15

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.

Rexall Sterile Artificial Tears Eye Drops is directionsput 1 to 2 drops in the affected eye(s) as needed.children under 6 years of age: ask a doctor. Marketed by Dolgencorp Inc, this product is identified by NDC 55910-522 and is authorized under FDA application part349.

Identification & Billing

NDC Package Code
55910-522-15
Package Description
1 BOTTLE in 1 CARTON / 15 mg in 1 BOTTLE
Product Code
55910-522
11-Digit Billing Format
55910052215
RxNorm Crosswalk
  • RxCUI: 259581 - glycerin 0.2 % / hypromellose 0.2 % / polyethylene glycol 400 1 % Ophthalmic Solution
  • RxCUI: 259581 - glycerin 2 MG/ML / hypromellose 2 MG/ML / polyethylene glycol 400 10 MG/ML Ophthalmic Solution
  • RxCUI: 259581 - glycerin 0.2 % / hypromellose 0.2 % / PEG 400 1 % Ophthalmic Solution

Clinical Specifications

Proprietary Name
Rexall Sterile Artificial Tears Eye Drops
Dosage Form
-
Usage Information
Directionsput 1 to 2 drops in the affected eye(s) as needed.children under 6 years of age: ask a doctor.

Regulatory & Marketing

Labeler Name
Dolgencorp Inc
FDA Application #
part349
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
06-30-2013
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 55910-522-15 identifies a specific commercial package of 1 bottle in 1 carton / 15 mg in 1 bottle of Rexall Sterile Artificial Tears Eye Drops, labeled by Dolgencorp Inc. 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 Dolgencorp Inc on June 30, 2013. The current certification is valid through December 31, 2019.

How is this Dolgencorp Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 55910052215. 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)
55910-522-15
11-Digit CMS (5-4-2)
55910-0522-15

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