Trimo San Jelly
NDC Package 59365-5030-0

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

Package Information

Trimo San (oxyquinoline sulfate and sodium lauryl sulfate) jellies is a medication used as To help restore and maintain normal vaginal acidity.To coat walls of vagina with a lubricating film that helps reduce odor-causing bacteria. This formulation utilizes a jelly delivery system. Marketed by Coopersurgical, Inc., this product is identified by NDC 59365-5030.

Identification & Billing

NDC Package Code
59365-5030-0
Package Description
113.4 g in 1 TUBE
Product Code
59365-5030
11-Digit Billing Format
59365503000
Billing Unit
GM - Billing unit of "gram" is used when a product is measured by its weight.
Units Per Package
113.4 GM
RxNorm Crosswalk
  • RxCUI: 999638 - oxyquinoline sulfate 0.025 % / sodium lauryl sulfate 0.01 % Vaginal Gel
  • RxCUI: 999638 - oxyquinoline sulfate 0.00025 MG/MG / sodium dodecyl sulfate 0.0001 MG/MG Vaginal Gel
  • RxCUI: 999640 - TRIMO-SAN 0.025 % / 0.01 % Vaginal Gel
  • RxCUI: 999640 - oxyquinoline sulfate 0.00025 MG/MG / sodium dodecyl sulfate 0.0001 MG/MG Vaginal Gel [Trimo San]
  • RxCUI: 999640 - Trimo San (oxyquinoline sulfate 0.025 % / sodium lauryl sulfate 0.01 % ) Vaginal Gel

Clinical Specifications

Proprietary Name
Trimo San
Non-Proprietary Name
Oxyquinoline Sulfate And Sodium Lauryl Sulfate
Substance Name
Oxyquinoline Sulfate; Sodium Lauryl Sulfate
Dosage Form
Jelly - A class of gels, which are semisolid systems that consist of suspensions made up of either small inorganic particles or large organic molecules interpenetrated by a liquid--in which the structural coherent matrix contains a high portion of liquid, usually water.
Administration Route
Vaginal - Administration into the vagina.
Active Ingredient(s)
Usage Information
This product is used as To help restore and maintain normal vaginal acidity.To coat walls of vagina with a lubricating film that helps reduce odor-causing bacteria.

Regulatory & Marketing

Labeler Name
Coopersurgical, Inc.
Product Type
Human Prescription Drug
Marketing Category
UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
Start Marketing Date
04-01-1977
End Marketing Date
10-31-2026
Exclude Flag
N
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 59365-5030-0 identifies a specific commercial package of 113.4 g in 1 tube of Trimo San, a human prescription drug labeled by Coopersurgical, Inc.. This jelly is formulated for vaginal use and contains oxyquinoline sulfate; sodium lauryl sulfate as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Coopersurgical, Inc. on April 01, 1977.

How is this Coopersurgical, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 59365503000. Quantities are measured in per "gm or gram", products billed per gram are products measured by weight.. There are 113.4 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 (5-4-1)
59365-5030-0
11-Digit CMS (5-4-2)
59365-5030-00

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