Cvs Health Nighttime Sleep Aid Liquid
NDC Package 69842-753-12

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

Package Information

Cvs Health Nighttime Sleep Aid (diphenhydramine hydrochloride) liquids is •take only one dose per day (24 hours) •Measure with dosing cup provided adults & children 12 yrs & over One Dose = 30 mL at bed time if needed or as directed by a doctor Children under 12 yrs do not use. This formulation utilizes a liquid delivery system. Marketed by Cvs Pharmacy,inc., this product is identified by NDC 69842-753 and is authorized under FDA application part341.

Identification & Billing

NDC Package Code
69842-753-12
Package Description
354 mL in 1 BOTTLE, PLASTIC
Product Code
69842-753
11-Digit Billing Format
69842075312
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Cvs Health Nighttime Sleep Aid
Non-Proprietary Name
Diphenhydramine Hydrochloride
Substance Name
Diphenhydramine Hydrochloride
Dosage Form
Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
DIPHENHYDRAMINE HYDROCHLORIDE 50 mg/30mL
Pharmacologic Class
Usage Information
•take only one dose per day (24 hours) •Measure with dosing cup provided adults & children 12 yrs & over One Dose = 30 mL at bed time if needed or as directed by a doctor Children under 12 yrs do not use

Regulatory & Marketing

Labeler Name
Cvs Pharmacy,inc.
Product Type
Human Otc Drug
FDA Application #
part341
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
10-11-2017
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 69842-753-12 identifies a specific commercial package of 354 ml in 1 bottle, plastic of Cvs Health Nighttime Sleep Aid, a human over the counter drug labeled by Cvs Pharmacy,inc.. This liquid 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 Cvs Pharmacy,inc. on October 11, 2017. The current certification is valid through December 31, 2026.

How is this Cvs Pharmacy,inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69842075312. 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)
69842-753-12
11-Digit CMS (5-4-2)
69842-0753-12

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