Ravicti Liquid
NDC Package 75987-050-06

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

Ravicti (glycerol phenylbutyrate) liquids is a medication used along with diet changes for long-term treatment of a certain inherited disorder (urea cycle disorder). This formulation utilizes a liquid delivery system. Marketed by Horizon Therapeutics Usa, Inc., this product is identified by NDC 75987-050 and is authorized under FDA application NDA203284.

Identification & Billing

NDC Package Code
75987-050-06
Package Description
1 BOTTLE in 1 CARTON / 25 mL in 1 BOTTLE
Product Code
75987-050
11-Digit Billing Format
75987005006
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Ravicti
Non-Proprietary Name
Glycerol Phenylbutyrate
Substance Name
Glycerol Phenylbutyrate
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)
GLYCEROL PHENYLBUTYRATE 1.1 g/mL
Pharmacologic Class
Usage Information
This medication is used along with diet changes for long-term treatment of a certain inherited disorder (urea cycle disorder). It helps remove a certain chemical (ammonia) from the body. Too much ammonia in the body can cause brain damage and sometimes death. This medication should not be used to treat sudden, severely high levels of ammonia in the body. Get medical help right away if you have sudden symptoms of too much ammonia, such as trouble thinking, vomiting, irritability, trouble speaking, trouble walking, fainting.

Regulatory & Marketing

Labeler Name
Horizon Therapeutics Usa, Inc.
Product Type
Human Prescription Drug
FDA Application #
NDA203284
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
02-28-2013
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 (75987-050). Click a package code to view its specific billing and regulatory data.

75987-050-07
4 BOTTLE in 1 CARTON / 25 mL in 1 BOTTLE

* 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 75987-050-06 identifies a specific commercial package of 1 bottle in 1 carton / 25 ml in 1 bottle of Ravicti, a human prescription drug labeled by Horizon Therapeutics Usa, Inc.. This liquid is formulated for oral use and contains glycerol phenylbutyrate 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 Horizon Therapeutics Usa, Inc. on February 28, 2013. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This medication is used along with diet changes for long-term treatment of a certain inherited disorder (urea cycle disorder). It helps remove a certain chemical (ammonia) from the body. Too much ammonia in the body can cause brain damage and sometimes death. This medication should not be used to treat sudden, severely high levels of ammonia in the body. Get medical help right away if you have sudden symptoms of too much ammonia, such as trouble thinking, vomiting, irritability, trouble speaking, trouble walking, fainting.

How is this Horizon Therapeutics Usa, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 75987005006. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. 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)
75987-050-06
11-Digit CMS (5-4-2)
75987-0050-06

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