Premium Lidocaine
NDC Package 69512-030-03

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.

Premium Lidocaine is a . Marketed by Alivio Medical Products, Llc, this product is identified by NDC 69512-030.

Identification & Billing

NDC Package Code
69512-030-03
Package Description
1 TUBE in 1 BOX / 50 g in 1 TUBE
Product Code
69512-030
11-Digit Billing Format
69512003003
Billing Unit
GM - Billing unit of "gram" is used when a product is measured by its weight.
Units Per Package
50 GM

Clinical Specifications

Proprietary Name
Premium Lidocaine
Dosage Form
-

Regulatory & Marketing

Labeler Name
Alivio Medical Products, Llc
Marketing Category
UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
Start Marketing Date
03-01-2015
End Marketing Date
06-09-2015
Listing Expiration
06-09-2015
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 69512-030-03 identifies a specific commercial package of 1 tube in 1 box / 50 g in 1 tube of Premium Lidocaine, labeled by Alivio Medical Products, Llc. This product is billed per "GM" gram and contains an estimated amount of 50 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 Alivio Medical Products, Llc on March 01, 2015. The current certification is valid through June 09, 2015.

How is this Alivio Medical Products, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69512003003. Quantities are measured in per "gm or gram", products billed per gram are products measured by weight.. There are 50 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)
69512-030-03
11-Digit CMS (5-4-2)
69512-0030-03

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