Provon Antibacterial Perineal Wash
NDC Package 21749-430-08

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.

Provon Antibacterial Perineal Wash is a . Marketed by Gojo Industries, Inc., this product is identified by NDC 21749-430 and is authorized under FDA application part333E.

Identification & Billing

NDC Package Code
21749-430-08
Package Description
236 mL in 1 PACKAGE
Product Code
21749-430
11-Digit Billing Format
21749043008

Clinical Specifications

Proprietary Name
Provon Antibacterial Perineal Wash
Dosage Form
-

Regulatory & Marketing

Labeler Name
Gojo Industries, Inc.
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
08-01-2010
End Marketing Date
12-01-2021
Listing Expiration
12-01-2021
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 21749-430-08 identifies a specific commercial package of 236 ml in 1 package of Provon Antibacterial Perineal Wash, labeled by Gojo Industries, Inc.. 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 Gojo Industries, Inc. on August 01, 2010. The current certification is valid through December 01, 2021.

How is this Gojo Industries, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 21749043008. 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)
21749-430-08
11-Digit CMS (5-4-2)
21749-0430-08

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