Vitastem-tetracycline Hydrochloride Spray
NDC Package 71262-003-00

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

Package Information

Vitastem-tetracycline Hydrochloride (tetracycline hydrochloride) sprays is first aid to help prevent the risk of skin infection in minor cuts, scrapes, or burns. This formulation utilizes a spray delivery system. Marketed by Viaderma Distribution, Inc., this product is identified by NDC 71262-003 and is authorized under FDA application M004.

Identification & Billing

NDC Package Code
71262-003-00
Package Description
1 BOTTLE, SPRAY in 1 BOX / 55 mL in 1 BOTTLE, SPRAY
Product Code
71262-003
11-Digit Billing Format
71262000300
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Vitastem-tetracycline Hydrochloride
Non-Proprietary Name
Tetracycline Hydrochloride
Substance Name
Tetracycline Hydrochloride
Dosage Form
Spray - A liquid minutely divided as by a jet of air or steam.
Administration Route
Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
Active Ingredient(s)
TETRACYCLINE HYDROCHLORIDE 30 mg/mL
Pharmacologic Class
Usage Information
First aid to help prevent the risk of skin infection in minor cuts, scrapes, or burns

Regulatory & Marketing

Labeler Name
Viaderma Distribution, Inc.
Product Type
Human Otc Drug
FDA Application #
M004
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
08-01-2019
Listing Expiration
12-31-2027
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 71262-003-00 identifies a specific commercial package of 1 bottle, spray in 1 box / 55 ml in 1 bottle, spray of Vitastem-tetracycline Hydrochloride, a human over the counter drug labeled by Viaderma Distribution, Inc.. This spray is formulated for topical use and contains tetracycline 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 Viaderma Distribution, Inc. on August 01, 2019. The current certification is valid through December 31, 2027.

How is this Viaderma Distribution, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 71262000300. 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)
71262-003-00
11-Digit CMS (5-4-2)
71262-0003-00

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