Walgreens Kit
NDC Package 0363-1500-01

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

Package Information

Walgreens (diphenhydramine hydrochloride, ibuprofen, hydrocortisone, bacitracin zinc, neomycin sulfate, polymyxin-b sulfate, lidocaine hcl, benzalkonium chloride, isopropyl alcohol, ethyl alcohol) kits is take every 4-6 hours, or as directed by a doctordo not take more than 6 times in 24 hoursAdults and children: (12 years and over)1 to 2 caplets Children under 12 years:do not use. This formulation utilizes a kit delivery system. Marketed by Walgreen Co., this product is identified by NDC 0363-1500 and is authorized under FDA application 505G(a)(3).

Identification & Billing

NDC Package Code
0363-1500-01
Package Description
1 KIT in 1 CASE * .9 g in 1 POUCH (61010-5600-1) * .34 g in 1 POUCH (51142-445-21) * .9 g in 1 POUCH (61010-5800-1) * 2 TABLET, COATED in 1 PACKET (47682-718-99) * .0019 L in 1 PACKET (61010-2017-0) * 1 TABLET, FILM COATED in 1 PACKET (47682-167-46) * .9 g in 1 PACKET (61010-5701-3)
Product Code
0363-1500
11-Digit Billing Format
00363150001
RxNorm Crosswalk
  • RxCUI: 1012100 - benzalkonium chloride 0.13 % / lidocaine HCl 0.5 % Topical Cream
  • RxCUI: 1012100 - benzalkonium chloride 1.3 MG/ML / lidocaine hydrochloride 5 MG/ML Topical Cream
  • RxCUI: 1012100 - benzalkonium chloride 0.13 % / lidocaine hydrochloride 0.5 % Topical Cream
  • RxCUI: 1039699 - ethanol 66.5 % Medicated Pad
  • RxCUI: 1039699 - ethanol 0.665 ML/ML Medicated Pad

Clinical Specifications

Proprietary Name
Walgreens
Non-Proprietary Name
Diphenhydramine Hydrochloride, Ibuprofen, Hydrocortisone, Bacitracin Zinc, Neomycin Sulfate, Polymyxin-b Sulfate, Lidocaine Hcl, Benzalkonium Chloride, Isopropyl Alcohol, Ethyl Alcohol
Dosage Form
Kit - A packaged collection of related material.
Administration Route
Oral - Administration to or by way of the mouth.
Usage Information
Take every 4-6 hours, or as directed by a doctordo not take more than 6 times in 24 hoursAdults and children: (12 years and over)1 to 2 caplets Children under 12 years:do not use

Regulatory & Marketing

Labeler Name
Walgreen Co.
Product Type
Human Otc Drug
FDA Application #
505G(a)(3)
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
07-17-2024
Listing Expiration
12-31-2027
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage
  • 0363 - Walgreen Co.
    • 0363-1500 - Walgreens
      • 0363-1500-01 - 1 KIT in 1 CASE * .9 g in 1 POUCH (61010-5600-1) * .34 g in 1 POUCH (51142-445-21) * .9 g in 1 POUCH (61010-5800-1) * 2 TABLET, COATED in 1 PACKET (47682-718-99) * .0019 L in 1 PACKET (61010-2017-0) * 1 TABLET, FILM COATED in 1 PACKET (47682-167-46) * .9 g in 1 PACKET (61010-5701-3)

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 0363-1500-01 identifies a specific commercial package of 1 kit in 1 case * .9 g in 1 pouch (61010-5600-1) * .34 g in 1 pouch (51142-445-21) * .9 g in 1 pouch (61010-5800-1) * 2 tablet, coated in 1 packet (47682-718-99) * .0019 l in 1 packet (61010-2017-0) * 1 tablet, film coated in 1 packet (47682-167-46) * .9 g in 1 packet (61010-5701-3) of Walgreens, a human over the counter drug labeled by Walgreen Co.. This kit is formulated for oral use and contains 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 Walgreen Co. on July 17, 2024. The current certification is valid through December 31, 2027.

How is this Walgreen Co. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00363150001. 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 (4-4-2)
0363-1500-01
11-Digit CMS (5-4-2)
00363-1500-01

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