Hylatears Liquid
NDC Package 72094-001-03

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

Package Information

Hylatears (eye drops) liquids is instill one or two drops in the affected eye(s) as needed. This formulation utilizes a liquid delivery system. Marketed by Hyalogic Llc, this product is identified by NDC 72094-001 and is authorized under FDA application M014.

Identification & Billing

NDC Package Code
72094-001-03
Package Description
20 mL in 1 BOTTLE, DROPPER
Product Code
72094-001
11-Digit Billing Format
72094000103

Clinical Specifications

Proprietary Name
Hylatears
Non-Proprietary Name
Eye Drops
Substance Name
Hypromellose 2910 (4000 Mpa.s)
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
Ophthalmic - Administration to the external eye.
Active Ingredient(s)
HYPROMELLOSE 2910 (4000 MPA.S) 3 mg/10mL
Usage Information
Instill one or two drops in the affected eye(s) as needed.

Regulatory & Marketing

Labeler Name
Hyalogic Llc
Product Type
Human Otc Drug
FDA Application #
M014
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-12-2018
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (72094-001). Click a package code to view its specific billing and regulatory data.

72094-001-02
1 BOTTLE, DROPPER in 1 BOX / 20 mL in 1 BOTTLE, DROPPER (72094-001-01)

* 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 72094-001-03 identifies a specific commercial package of 20 ml in 1 bottle, dropper of Hylatears, a human over the counter drug labeled by Hyalogic Llc. This liquid is formulated for ophthalmic use and contains hypromellose 2910 (4000 mpa.s) 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 Hyalogic Llc on February 12, 2018. The current certification is valid through December 31, 2026.

How is this Hyalogic Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72094000103. 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)
72094-001-03
11-Digit CMS (5-4-2)
72094-0001-03

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