Agrobac Pure Foam Solution
NDC Package 11084-024-01

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

Agrobac Pure Foam (benzalkonium chloride) solution is apply to dry handsadd waterlather hands for 30 secondsrinse and dry hands thoroughly. This formulation utilizes a solution delivery system. Marketed by Sc Johnson Professional Usa, Inc., this product is identified by NDC 11084-024 and is authorized under FDA application 505G(a)(3).

Identification & Billing

NDC Package Code
11084-024-01
Package Description
47 mL in 1 BOTTLE, PLASTIC
Product Code
11084-024
11-Digit Billing Format
11084002401

Clinical Specifications

Proprietary Name
Agrobac Pure Foam
Non-Proprietary Name
Benzalkonium Chloride
Substance Name
Benzalkonium Chloride
Dosage Form
Solution - A clear, homogeneous liquid1 dosage form that contains one or more chemical substances dissolved in a solvent or mixture of mutually miscible solvents.
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)
BENZALKONIUM CHLORIDE .13 g/100mL
Usage Information
Apply to dry handsadd waterlather hands for 30 secondsrinse and dry hands thoroughly

Regulatory & Marketing

Labeler Name
Sc Johnson Professional Usa, Inc.
Product Type
Human Otc Drug
FDA Application #
505G(a)(3)
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
10-01-2018
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
Yes

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 (11084-024). Click a package code to view its specific billing and regulatory data.

11084-024-12
1200 mL in 1 BOTTLE, PLASTIC
11084-024-20
2000 mL in 1 BOTTLE, PLASTIC
11084-024-27
1000 mL in 1 BOTTLE, PLASTIC
11084-024-66
1000 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 11084-024-01 identifies a specific commercial package of 47 ml in 1 bottle, plastic of Agrobac Pure Foam, a human over the counter drug labeled by Sc Johnson Professional Usa, Inc.. This solution is formulated for topical use and contains benzalkonium chloride 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 Sc Johnson Professional Usa, Inc. on October 01, 2018. The current certification is valid through December 31, 2026.

How is this Sc Johnson Professional Usa, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 11084002401. 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)
11084-024-01
11-Digit CMS (5-4-2)
11084-0024-01

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