Oil-free Acne Wash
NDC Package 40104-291-01

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.

Oil-free Acne Wash is use as often as needed in shower or bath.Apply to washcloth or brushWork lather into skin, especially affected areas, rinse well. Marketed by Ningbo Pulisi Daily Chemical Products Co.,ltd., this product is identified by NDC 40104-291 and is authorized under FDA application part333D.

Identification & Billing

NDC Package Code
40104-291-01
Package Description
236 mL in 1 BOTTLE, PUMP
Product Code
40104-291
11-Digit Billing Format
40104029101
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Oil-free Acne Wash
Dosage Form
-
Usage Information
Use as often as needed in shower or bath.Apply to washcloth or brushWork lather into skin, especially affected areas, rinse well.

Regulatory & Marketing

Labeler Name
Ningbo Pulisi Daily Chemical Products Co.,ltd.
FDA Application #
part333D
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
08-17-2017
Listing Expiration
12-31-2019
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 40104-291-01 identifies a specific commercial package of 236 ml in 1 bottle, pump of Oil-free Acne Wash, labeled by Ningbo Pulisi Daily Chemical Products Co.,ltd.. 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 Ningbo Pulisi Daily Chemical Products Co.,ltd. on August 17, 2017. The current certification is valid through December 31, 2019.

How is this Ningbo Pulisi Daily Chemical Products Co.,ltd. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 40104029101. 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)
40104-291-01
11-Digit CMS (5-4-2)
40104-0291-01

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