Quality Choice Infants Dye Free Gas Relief Emulsion
NDC Package 63868-696-30

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

Package Information

Quality Choice Infants Dye Free Gas Relief (simethicone) emulsions is a medication used to relieve symptoms of extra gas caused by air swallowing or certain foods/infant formulas. This formulation utilizes a emulsion delivery system. Marketed by Chain Drug Marketing Association, this product is identified by NDC 63868-696 and is authorized under FDA application M002.

Identification & Billing

NDC Package Code
63868-696-30
Package Description
1 BOTTLE, DROPPER in 1 CARTON / 30 mL in 1 BOTTLE, DROPPER
Product Code
63868-696
11-Digit Billing Format
63868069630
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Quality Choice Infants Dye Free Gas Relief
Non-Proprietary Name
Simethicone
Substance Name
Dimethicone, Unspecified
Dosage Form
Emulsion - A dosage form consisting of a two-phase system comprised of at least two immiscible liquids1, one of which is dispersed as droplets (internal or dispersed phase) within the other liquid (external or continuous phase), generally stabilized with one or more emulsifying agents. (Note: Emulsion is used as a dosage form term unless a more specific term is applicable, e.g. cream, lotion, ointment.)
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
DIMETHICONE, UNSPECIFIED 20 mg/.3mL
Pharmacologic Class
Skin Barrier Activity - [PE] (Physiologic Effect)
Usage Information
This product is used to relieve symptoms of extra gas caused by air swallowing or certain foods/infant formulas. Simethicone helps break up gas bubbles in the gut.

Regulatory & Marketing

Labeler Name
Chain Drug Marketing Association
Product Type
Human Otc Drug
FDA Application #
M002
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
12-17-2018
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 63868-696-30 identifies a specific commercial package of 1 bottle, dropper in 1 carton / 30 ml in 1 bottle, dropper of Quality Choice Infants Dye Free Gas Relief, a human over the counter drug labeled by Chain Drug Marketing Association. This emulsion is formulated for oral use and contains dimethicone, unspecified 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 Chain Drug Marketing Association on December 17, 2018. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This product is used to relieve symptoms of extra gas caused by air swallowing or certain foods/infant formulas. Simethicone helps break up gas bubbles in the gut.

How is this Chain Drug Marketing Association product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 63868069630. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. 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)
63868-696-30
11-Digit CMS (5-4-2)
63868-0696-30

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