Revitaderm Psoriasis Ointment
NDC Package 63347-112-01

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

Package Information

Revitaderm Psoriasis (coal tar) ointment is directions  Apply to affected areas as directed by a doctor.Apply as needed to affected areas as often as needed (up to four times per day). This formulation utilizes a ointment delivery system. Marketed by Blaine Labs Inc., this product is identified by NDC 63347-112 and is authorized under FDA application M032.

Identification & Billing

NDC Package Code
63347-112-01
Package Description
118 mL in 1 JAR
Product Code
63347-112
11-Digit Billing Format
63347011201
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Revitaderm Psoriasis
Non-Proprietary Name
Coal Tar
Substance Name
Coal Tar
Dosage Form
Ointment - A semisolid3 dosage form, usually containing <20% water and volatiles5 and >50% hydrocarbons, waxes, or polyols as the vehicle. This dosage form is generally for external application to the skin or mucous membranes.
Administration Route
Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
Active Ingredient(s)
COAL TAR 2 mg/100mL
Usage Information
Directions  Apply to affected areas as directed by a doctor.Apply as needed to affected areas as often as needed (up to four times per day)

Regulatory & Marketing

Labeler Name
Blaine Labs Inc.
Product Type
Human Otc Drug
FDA Application #
M032
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
11-01-2011
Listing Expiration
12-31-2026
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 63347-112-01 identifies a specific commercial package of 118 ml in 1 jar of Revitaderm Psoriasis, a human over the counter drug labeled by Blaine Labs Inc.. This ointment is formulated for topical use and contains coal tar 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 Blaine Labs Inc. on November 01, 2011. The current certification is valid through December 31, 2026.

How is this Blaine Labs Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 63347011201. 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)
63347-112-01
11-Digit CMS (5-4-2)
63347-0112-01

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