Dextromethorphan Hydrobromide And Guaifenesin Syrup
NDC Package 85722-0002-4

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

Dextromethorphan Hydrobromide And Guaifenesin syrups is take evey 4 hoursdo not take more than 6 doses in any 24-hour periodmeasure only with dosing cup providedkeep dosing cup with productAgeDoseAdults and children 12 years and over5 mL every 4 hoursChildren under 12 yearsdo not use. This formulation utilizes a syrup delivery system. Marketed by Kjd Pharma Private Limited, this product is identified by NDC 85722-0002 and is authorized under FDA application M012.

Identification & Billing

NDC Package Code
85722-0002-4
Package Description
118 mL in 1 BOTTLE
Product Code
85722-0002
11-Digit Billing Format
85722000204
RxNorm Crosswalk
  • RxCUI: 1117394 - dextromethorphan HBr 20 MG / guaiFENesin 300 MG in 5 mL Oral Solution
  • RxCUI: 1117394 - dextromethorphan hydrobromide 4 MG/ML / guaifenesin 60 MG/ML Oral Solution
  • RxCUI: 1117394 - dextromethorphan hydrobromide 20 MG / guaifenesin 300 MG per 5 ML Oral Solution

Clinical Specifications

Proprietary Name
Dextromethorphan Hydrobromide And Guaifenesin
Non-Proprietary Name
Dextromethorphan Hydrobromide And Guaifenesin
Substance Name
Dextromethorphan Hydrobromide; Guaifenesin
Dosage Form
Syrup - An oral solution containing high concentrations of sucrose or other sugars; the term has also been used to include any other liquid dosage form prepared in a sweet and viscid vehicle, including oral suspensions.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
Take evey 4 hoursdo not take more than 6 doses in any 24-hour periodmeasure only with dosing cup providedkeep dosing cup with productAgeDoseAdults and children 12 years and over5 mL every 4 hoursChildren under 12 yearsdo not use

Regulatory & Marketing

Labeler Name
Kjd Pharma Private Limited
Product Type
Human Otc Drug
FDA Application #
M012
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-01-2021
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 (85722-0002). Click a package code to view its specific billing and regulatory data.

85722-0002-6
473 mL in 1 BOTTLE
85722-0002-8
236 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 85722-0002-4 identifies a specific commercial package of 118 ml in 1 bottle of Dextromethorphan Hydrobromide And Guaifenesin, a human over the counter drug labeled by Kjd Pharma Private Limited. This syrup is formulated for oral use and contains dextromethorphan hydrobromide; guaifenesin 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 Kjd Pharma Private Limited on February 01, 2021. The current certification is valid through December 31, 2026.

How is this Kjd Pharma Private Limited product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 85722000204. 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 (5-4-1)
85722-0002-4
11-Digit CMS (5-4-2)
85722-0002-04

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