Allergy Dyefree Capsule, Liquid Filled
NDC Package 69168-409-86

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

Package Information

Allergy Dyefree capsules is take every 4 to 6 hoursdo not take more than 6 doses in 24 hoursAdults and children 12 years and over: 1 to 2 softgelsChildren 6 to under 12 years: 1 softgelChildren under 6 years: do not use this product in children under 6 years of age. This formulation utilizes a capsule, liquid filled delivery system. Marketed by Allegiant Health, this product is identified by NDC 69168-409 and is authorized under FDA application M009.

Identification & Billing

NDC Package Code
69168-409-86
Package Description
12 CAPSULE, LIQUID FILLED in 1 BLISTER PACK
Product Code
69168-409
11-Digit Billing Format
69168040986
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Allergy Dyefree
Non-Proprietary Name
Allergy Dyefree
Substance Name
Diphenhydramine Hydrochloride
Dosage Form
Capsule, Liquid Filled - A solid dosage form in which the drug is enclosed within a soluble, gelatin shell which is plasticized by the addition of a polyol, such as sorbitol or glycerin, and is therefore of a somewhat thicker consistency than that of a hard shell capsule; typically, the active ingredients are dissolved or suspended in a liquid vehicle.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
DIPHENHYDRAMINE HYDROCHLORIDE 25 mg/1
Pharmacologic Class
Usage Information
Take every 4 to 6 hoursdo not take more than 6 doses in 24 hoursAdults and children 12 years and over: 1 to 2 softgelsChildren 6 to under 12 years: 1 softgelChildren under 6 years: do not use this product in children under 6 years of age

Regulatory & Marketing

Labeler Name
Allegiant Health
Product Type
Human Otc Drug
FDA Application #
M009
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
09-15-2013
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 69168-409-86 identifies a specific commercial package of 12 capsule, liquid filled in 1 blister pack of Allergy Dyefree, a human over the counter drug labeled by Allegiant Health. This capsule, liquid filled is formulated for oral use and contains diphenhydramine hydrochloride 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 Allegiant Health on September 15, 2013. The current certification is valid through December 31, 2026.

How is this Allegiant Health product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69168040986. 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)
69168-409-86
11-Digit CMS (5-4-2)
69168-0409-86

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