Ixoba M
NDC Package 73614-454-03

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 inactivated by the FDA.

Ixoba M is a . Marketed by Brisk Pharmaceuticals, Inc., this product is identified by NDC 73614-454.

Identification & Billing

NDC Package Code
73614-454-03
Package Description
1 KIT in 1 CARTON * 1 BOTTLE in 1 CARTON / 5 mL in 1 BOTTLE * 1 BOTTLE in 1 CARTON / 3 mL in 1 BOTTLE * 5 mL in 1 BOTTLE
Product Code
73614-454
11-Digit Billing Format
73614045403
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Ixoba M
Dosage Form
-

Regulatory & Marketing

Labeler Name
Brisk Pharmaceuticals, Inc.
Marketing Category
UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
Start Marketing Date
08-26-2021
Listing Expiration
12-31-2022
Exclude Flag
I
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 73614-454-03 identifies a specific commercial package of 1 kit in 1 carton * 1 bottle in 1 carton / 5 ml in 1 bottle * 1 bottle in 1 carton / 3 ml in 1 bottle * 5 ml in 1 bottle of Ixoba M, labeled by Brisk Pharmaceuticals, Inc.. 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 Brisk Pharmaceuticals, Inc. on August 26, 2021. The current certification is valid through December 31, 2022.

How is this Brisk Pharmaceuticals, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 73614045403. 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)
73614-454-03
11-Digit CMS (5-4-2)
73614-0454-03

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