Benzethonium Chloride And Dyclonine Hydrochloride
NDC Package 11822-0779-3

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 discontinued by the firm.

Benzethonium Chloride And Dyclonine Hydrochloride is for adults and children 2 years of age or olderclean affected areaapply a smalll amount on the area 1 to 3 times daily and let drya second coating may be applied for extra protectionchildren under 2 years of age: consult a doctor. Marketed by Rite Aid Corporation, this product is identified by NDC 11822-0779 and is authorized under FDA application M003.

Identification & Billing

NDC Package Code
11822-0779-3
Package Description
30 mL in 1 BOTTLE, WITH APPLICATOR
Product Code
11822-0779
11-Digit Billing Format
11822077903

Clinical Specifications

Proprietary Name
Benzethonium Chloride And Dyclonine Hydrochloride
Dosage Form
-
Usage Information
For adults and children 2 years of age or olderclean affected areaapply a smalll amount on the area 1 to 3 times daily and let drya second coating may be applied for extra protectionchildren under 2 years of age: consult a doctor

Regulatory & Marketing

Labeler Name
Rite Aid Corporation
FDA Application #
M003
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-01-2020
End Marketing Date
04-20-2026
Listing Expiration
04-20-2026
Exclude Flag
D
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 11822-0779-3 identifies a specific commercial package of 30 ml in 1 bottle, with applicator of Benzethonium Chloride And Dyclonine Hydrochloride, labeled by Rite Aid Corporation. 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 Rite Aid Corporation on February 01, 2020. The current certification is valid through April 20, 2026.

How is this Rite Aid Corporation product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 11822077903. 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)
11822-0779-3
11-Digit CMS (5-4-2)
11822-0779-03

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