Sodium Sulfate, Potassium Sulfate And Magnesium Sulfate Solution
NDC Package 67877-725-92

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

Package Information

Sodium Sulfate, Potassium Sulfate And Magnesium Sulfate solution is sodium sulfate, potassium sulfate and magnesium sulfate oral solution is indicated for cleansing of the colon as a preparation for colonoscopy in adult patients.Pediatric use information is approved for Braintree Laboratories, Inc.’s SUPREP BOWEL PREP KIT (sodium sulfate, potassium sulfate, and magnesium sulfate) oral solution. This formulation utilizes a solution delivery system. Marketed by Ascend Laboratories, Llc, this product is identified by NDC 67877-725 and is authorized under FDA application ANDA213924.

Identification & Billing

NDC Package Code
67877-725-92
Package Description
2 BOTTLE, PLASTIC in 1 CARTON / 177 mL in 1 BOTTLE, PLASTIC
Product Code
67877-725
11-Digit Billing Format
67877072592
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
RxNorm Crosswalk
  • RxCUI: 1120068 - magnesium sulfate 1.6 GM / potassium sulfate 3.13 GM / sodium sulfate 17.5 GM in 177 mL Oral Solution
  • RxCUI: 1120068 - magnesium sulfate 0.0277 MEQ/ML / potassium sulfate 0.0374 MEQ/ML / sodium sulfate 0.257 MEQ/ML Oral Solution
  • RxCUI: 1120068 - Magnesium Sulfate 0.0277 MEQ/ML / K+ sulfate 0.0374 MEQ/ML / sodium sulfate 0.257 MEQ/ML Oral Solution
  • RxCUI: 1120068 - Magnesium Sulfate 0.0277 MEQ/ML / Pot sulfate 0.0374 MEQ/ML / sodium sulfate 0.257 MEQ/ML Oral Solution
  • RxCUI: 1120068 - magnesium sulfate 1.6 GM / potassium sulfate 3.13 GM / sodium sulfate 17.5 GM per 177 ML Oral Solution

Clinical Specifications

Proprietary Name
Sodium Sulfate, Potassium Sulfate And Magnesium Sulfate
Non-Proprietary Name
Sodium Sulfate, Potassium Sulfate And Magnesium Sulfate
Substance Name
Magnesium Sulfate, Unspecified Form; Potassium Sulfate; Sodium Sulfate
Dosage Form
Solution - A clear, homogeneous liquid1 dosage form that contains one or more chemical substances dissolved in a solvent or mixture of mutually miscible solvents.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
Sodium sulfate, potassium sulfate and magnesium sulfate oral solution is indicated for cleansing of the colon as a preparation for colonoscopy in adult patients.Pediatric use information is approved for Braintree Laboratories, Inc.’s SUPREP BOWEL PREP KIT (sodium sulfate, potassium sulfate, and magnesium sulfate) oral solution. However, due to Braintree Laboratories, Inc.’s marketing exclusivity rights, this drug product is not labeled with that pediatric information.

Regulatory & Marketing

Labeler Name
Ascend Laboratories, Llc
Product Type
Human Prescription Drug
FDA Application #
ANDA213924
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
03-29-2024
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 67877-725-92 identifies a specific commercial package of 2 bottle, plastic in 1 carton / 177 ml in 1 bottle, plastic of Sodium Sulfate, Potassium Sulfate And Magnesium Sulfate, a human prescription drug labeled by Ascend Laboratories, Llc. This solution is formulated for oral use and contains magnesium sulfate, unspecified form; potassium sulfate; sodium 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 Ascend Laboratories, Llc on March 29, 2024. The current certification is valid through December 31, 2026.

How is this Ascend Laboratories, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 67877072592. 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)
67877-725-92
11-Digit CMS (5-4-2)
67877-0725-92

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