Tizanidine
NDC Package 69420-1502-1

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

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was discontinued by the firm.

Tizanidine is a . Marketed by Sa3, Llc, this product is identified by NDC 69420-1502 and is authorized under FDA application ANDA209605.

Identification & Billing

NDC Package Code
69420-1502-1
Package Description
150 CAPSULE in 1 BOTTLE
Product Code
69420-1502
11-Digit Billing Format
69420150201
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
150 EA

Clinical Specifications

Proprietary Name
Tizanidine
Dosage Form
-

Regulatory & Marketing

Labeler Name
Sa3, Llc
FDA Application #
ANDA209605
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
10-01-2018
End Marketing Date
01-01-2022
Listing Expiration
01-01-2022
Exclude Flag
D
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 69420-1502-1 identifies a specific commercial package of 150 capsule in 1 bottle of Tizanidine, labeled by Sa3, Llc. This product is billed for "EA" each discreet unit and contains an estimated amount of 150 billable units per package. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Sa3, Llc on October 01, 2018. The current certification is valid through January 01, 2022.

How is this Sa3, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69420150201. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 150 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 (5-4-1)
69420-1502-1
11-Digit CMS (5-4-2)
69420-1502-01

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