Drs Pharmacy Triple Antibiotic Pain Plus Itch Plus Scar
NDC Package 80489-412-01

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

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Drs Pharmacy Triple Antibiotic Pain Plus Itch Plus Scar is clean the affected areaapply a small amount of this product (an amount equal tot the surface area of the tip of a finer) on the area 1 to 3 times dailymay be covered with a sterile bandage. Marketed by Ol Pharma Tech, Llc, this product is identified by NDC 80489-412 and is authorized under FDA application M003.

Identification & Billing

NDC Package Code
80489-412-01
Package Description
1 TUBE in 1 CARTON / 14 g in 1 TUBE
Product Code
80489-412
11-Digit Billing Format
80489041201
RxNorm Crosswalk
  • RxCUI: 1359350 - bacitracin 500 UNT / neomycin 3.5 MG / polymyxin B 10,000 UNT / pramoxine HCl 10 MG in GM Topical Ointment
  • RxCUI: 1359350 - bacitracin 0.5 UNT/MG / neomycin 0.0035 MG/MG / polymyxin B 10 UNT/MG / pramoxine hydrochloride 0.01 MG/MG Topical Ointment
  • RxCUI: 1359350 - bacitracin 500 UNT / neomycin 3.5 MG / polymyxin B 10,000 UNT / pramoxine HCl 10 MG per GM Topical Ointment

Clinical Specifications

Proprietary Name
Drs Pharmacy Triple Antibiotic Pain Plus Itch Plus Scar
Dosage Form
-
Usage Information
Clean the affected areaapply a small amount of this product (an amount equal tot the surface area of the tip of a finer) on the area 1 to 3 times dailymay be covered with a sterile bandage

Regulatory & Marketing

Labeler Name
Ol Pharma Tech, Llc
FDA Application #
M003
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-16-2021
Listing Expiration
12-31-2025
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (80489-412). Click a package code to view its specific billing and regulatory data.

80489-412-02
1 TUBE in 1 CARTON / 28.3 g in 1 TUBE

* 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 80489-412-01 identifies a specific commercial package of 1 tube in 1 carton / 14 g in 1 tube of Drs Pharmacy Triple Antibiotic Pain Plus Itch Plus Scar, labeled by Ol Pharma Tech, Llc. 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 Ol Pharma Tech, Llc on February 16, 2021. The current certification is valid through December 31, 2025.

How is this Ol Pharma Tech, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 80489041201. 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)
80489-412-01
11-Digit CMS (5-4-2)
80489-0412-01

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