Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate Tablet
NDC Package 64980-104-01

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

Package Information

Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate tablets is pHOSPHA 250TM NEUTRAL increases urinary phosphate and pyrophosphate. This formulation utilizes a tablet delivery system. Marketed by Rising Pharma Holdings, Inc., this product is identified by NDC 64980-104.

Identification & Billing

NDC Package Code
64980-104-01
Package Description
100 TABLET in 1 BOTTLE
Product Code
64980-104
11-Digit Billing Format
64980010401
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
100 EA
RxNorm Crosswalk
  • RxCUI: 200251 - sodium phosphate, dibasic 852 MG / potassium phosphate, monobasic 155 MG / sodium phosphate, monobasic 130 MG Oral Tablet
  • RxCUI: 200251 - potassium phosphate 155 MG / sodium phosphate, dibasic 852 MG / sodium phosphate, monobasic 130 MG Oral Tablet
  • RxCUI: 200251 - K+ phosphate 155 MG / Sodium Phosphate, Dibasic 852 MG / Sodium Phosphate, Monobasic 130 MG Oral Tablet
  • RxCUI: 200251 - Pot phosphate 155 MG / Sodium Phosphate, Dibasic 852 MG / Sodium Phosphate, Monobasic 130 MG Oral Tablet

Clinical Specifications

Proprietary Name
Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate
Non-Proprietary Name
Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate
Substance Name
Potassium Phosphate, Monobasic; Sodium Phosphate, Dibasic, Anhydrous; Sodium Phosphate, Monobasic, Monohydrate
Dosage Form
Tablet - A solid dosage form containing medicinal substances with or without suitable diluents.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Usage Information
PHOSPHA 250TM NEUTRAL increases urinary phosphate and pyrophosphate. As a phosphorus supplement, each tablet supplies 25% of the U.S. Recommended Daily Allowance (U.S. RDA) of phosphorus for adults and children over 4 years of age.

Regulatory & Marketing

Labeler Name
Rising Pharma Holdings, 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
06-28-2012
End Marketing Date
12-31-2028
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 64980-104-01 identifies a specific commercial package of 100 tablet in 1 bottle of Dibasic Sodium Phosphate, Monobasic Potassium Phosphate And Monobasic Sodium Phosphate, a human prescription drug labeled by Rising Pharma Holdings, Inc.. This tablet is formulated for oral use and contains potassium phosphate, monobasic; sodium phosphate, dibasic, anhydrous; sodium phosphate, monobasic, monohydrate 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 Rising Pharma Holdings, Inc. on June 28, 2012.

How is this Rising Pharma Holdings, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 64980010401. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 100 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 (5-3-2)
64980-104-01
11-Digit CMS (5-4-2)
64980-0104-01

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