Cocoa Butter Petroleum Jelly
NDC Package 0363-1802-06

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

Package Information

Cocoa Butter Petroleum Jelly (white petrolatum jelly) jellies is usesFor the temporary protection of minor cuts, scrapes, burnsHelps to temporarily protect chafed, chapped, cracked or windburned skin and lips. This formulation utilizes a jelly delivery system. Marketed by Walgreens, this product is identified by NDC 0363-1802 and is authorized under FDA application M016.

Identification & Billing

NDC Package Code
0363-1802-06
Package Description
212 g in 1 JAR
Product Code
0363-1802
11-Digit Billing Format
00363180206
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Cocoa Butter Petroleum Jelly
Non-Proprietary Name
White Petrolatum Jelly
Substance Name
White Petrolatum
Dosage Form
Jelly - A class of gels, which are semisolid systems that consist of suspensions made up of either small inorganic particles or large organic molecules interpenetrated by a liquid--in which the structural coherent matrix contains a high portion of liquid, usually water.
Administration Route
Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
Active Ingredient(s)
WHITE PETROLATUM 99 g/100g
Usage Information
UsesFor the temporary protection of minor cuts, scrapes, burnsHelps to temporarily protect chafed, chapped, cracked or windburned skin and lips.

Regulatory & Marketing

Labeler Name
Walgreens
Product Type
Human Otc Drug
FDA Application #
M016
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-27-2025
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 0363-1802-06 identifies a specific commercial package of 212 g in 1 jar of Cocoa Butter Petroleum Jelly, a human over the counter drug labeled by Walgreens. This jelly is formulated for topical use and contains white petrolatum 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 Walgreens on March 27, 2025. The current certification is valid through December 31, 2026.

How is this Walgreens product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00363180206. 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)
0363-1802-06
11-Digit CMS (5-4-2)
00363-1802-06

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