Foaming Mousse Hand Sanitizer
NDC Package 17630-3093-1

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.

Foaming Mousse Hand Sanitizer is • Shake well before using. Marketed by Accra Pac, Inc. (dba Kik-indiana), this product is identified by NDC 17630-3093 and is authorized under FDA application part333E.

Identification & Billing

NDC Package Code
17630-3093-1
Package Description
1 mL in 1 BOTTLE
Product Code
17630-3093
11-Digit Billing Format
17630309301
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Foaming Mousse Hand Sanitizer
Dosage Form
-
Usage Information
• Shake well before using. • Spray product on hands, enough to cover all surfaces. Rub hands together until all surfaces are wet and fully covered. Continue rubbing untiil hands feel dry. Do not rinse or wipe off sanitizer. • Supervise children under 6 years of age when using this product to avoid swallowing.

Regulatory & Marketing

Labeler Name
Accra Pac, Inc. (dba Kik-indiana)
FDA Application #
part333E
Marketing Category
OTC MONOGRAPH NOT FINAL - A product marketed pursuant to an Over-the-Counter (OTC) Drug Monograph that is not final.
Start Marketing Date
03-20-2020
Listing Expiration
12-31-2023
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 17630-3093-1 identifies a specific commercial package of 1 ml in 1 bottle of Foaming Mousse Hand Sanitizer, labeled by Accra Pac, Inc. (dba Kik-indiana). 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 Accra Pac, Inc. (dba Kik-indiana) on March 20, 2020. The current certification is valid through December 31, 2023.

How is this Accra Pac, Inc. (dba Kik-indiana) product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 17630309301. 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)
17630-3093-1
11-Digit CMS (5-4-2)
17630-3093-01

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