Glycerin, Phenylephrine Hydrochloride, Pramoxine, White Petrolatum
NDC Package 11673-572-24

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

Package Information

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

Glycerin, Phenylephrine Hydrochloride, Pramoxine, White Petrolatum is adults:When practical, cleanse the affected area by patting or blotting with an appropriate cleansing wipe. Marketed by Target Corporation, this product is identified by NDC 11673-572 and is authorized under FDA application part346.

Identification & Billing

NDC Package Code
11673-572-24
Package Description
1 TUBE, WITH APPLICATOR in 1 BOX / 51 g in 1 TUBE, WITH APPLICATOR
Product Code
11673-572
11-Digit Billing Format
11673057224
Billing Unit
GM - Billing unit of "gram" is used when a product is measured by its weight.
Units Per Package
51 GM
RxNorm Crosswalk
  • RxCUI: 1293649 - glycerin 14.4 % / phenylephrine HCl 0.25 % / pramoxine HCl 1 % / white petrolatum 15 % Rectal Cream
  • RxCUI: 1293649 - glycerin 144 MG/ML / petrolatum 150 MG/ML / phenylephrine hydrochloride 2.5 MG/ML / pramoxine hydrochloride 10 MG/ML Rectal Cream
  • RxCUI: 1293649 - glycerin 14.4 % / phenylephrine hydrochloride 0.25 % / pramoxine hydrochloride 1 % / white petrolatum 15 % Rectal Cream

Clinical Specifications

Proprietary Name
Glycerin, Phenylephrine Hydrochloride, Pramoxine, White Petrolatum
Dosage Form
-
Usage Information
Adults:When practical, cleanse the affected area by patting or blotting with an appropriate cleansing wipe. Gently dry by patting or blotting with a tissue or soft cloth before applying cream.When first opening the tube, puncture foil seal with top end of capApply externally or in the lower portion of the anal canal onlyApply externally to the affected area up to 4 times daily, especially at night, in the morning or after each bowel movementFor application in the lower anal canal: remove cover from dispensing cap. Attach dispensing cap to tube. Lubricate applicator well, then gently insert applicator into the rectum.Thoroughly clean dispensing cap after each use and replace coverChildren under 12 years:  ask a doctor.

Regulatory & Marketing

Labeler Name
Target Corporation
FDA Application #
part346
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
04-01-2009
Listing Expiration
12-31-2017
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 11673-572-24 identifies a specific commercial package of 1 tube, with applicator in 1 box / 51 g in 1 tube, with applicator of Glycerin, Phenylephrine Hydrochloride, Pramoxine, White Petrolatum, labeled by Target Corporation. This product is billed per "GM" gram and contains an estimated amount of 51 billable units per package. 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 Target Corporation on April 01, 2009. The current certification is valid through December 31, 2017.

How is this Target Corporation product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 11673057224. Quantities are measured in per "gm or gram", products billed per gram are products measured by weight.. There are 51 total billable units per package. 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)
11673-572-24
11-Digit CMS (5-4-2)
11673-0572-24

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