Pain Relief Pm Tablet, Film Coated
NDC Package 59779-894-12

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

Package Information

Pain Relief Pm (acetaminophen, aspirin, diphenhydramine citrate) tablets is do not take more than directedadults and children 12 years and over: take 2 caplets at bedtime, with a full glass of waterdo not take more than 2 caplets in 24 hours, unless directed by a doctorchildren under 12 years: do not use. This formulation utilizes a tablet, film coated delivery system. Marketed by Cvs Pharmacy, this product is identified by NDC 59779-894 and is authorized under FDA application M013.

Identification & Billing

NDC Package Code
59779-894-12
Package Description
1 BOTTLE in 1 CARTON / 100 TABLET, FILM COATED in 1 BOTTLE
Product Code
59779-894
11-Digit Billing Format
59779089412
RxNorm Crosswalk
  • RxCUI: 1593110 - acetaminophen 250 MG / aspirin 250 MG / diphenhydrAMINE citrate 38 MG Oral Tablet
  • RxCUI: 1593110 - acetaminophen 250 MG / aspirin 250 MG / diphenhydramine citrate 38 MG Oral Tablet
  • RxCUI: 1593110 - APAP 250 MG / ASA 250 MG / Diphenhydramine Citrate 38 MG Oral Tablet

Clinical Specifications

Proprietary Name
Pain Relief Pm
Non-Proprietary Name
Acetaminophen, Aspirin, Diphenhydramine Citrate
Substance Name
Acetaminophen; Aspirin; Diphenhydramine Citrate
Dosage Form
Tablet, Film Coated - A solid dosage form that contains medicinal substances with or without suitable diluents and is coated with a thin layer of a water-insoluble or water-soluble polymer.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
Do not take more than directedadults and children 12 years and over: take 2 caplets at bedtime, with a full glass of waterdo not take more than 2 caplets in 24 hours, unless directed by a doctorchildren under 12 years: do not use

Regulatory & Marketing

Labeler Name
Cvs Pharmacy
Product Type
Human Otc Drug
FDA Application #
M013
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
08-31-2016
End Marketing Date
06-30-2027
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 59779-894-12 identifies a specific commercial package of 1 bottle in 1 carton / 100 tablet, film coated in 1 bottle of Pain Relief Pm, a human over the counter drug labeled by Cvs Pharmacy. This tablet, film coated is formulated for oral use and contains acetaminophen; aspirin; diphenhydramine citrate 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 Cvs Pharmacy on August 31, 2016.

How is this Cvs Pharmacy product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 59779089412. 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)
59779-894-12
11-Digit CMS (5-4-2)
59779-0894-12

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