Pain Relief Patch Lidocaine Patch
NDC Package 42507-960-06

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

Package Information

Pain Relief Patch Lidocaine (lidocaine) patches is a medication used to help reduce itching and pain from certain skin conditions (such as scrapes, minor skin irritations, insect bites). This formulation utilizes a patch delivery system. Marketed by Hyvee, this product is identified by NDC 42507-960 and is authorized under FDA application M017.

Identification & Billing

NDC Package Code
42507-960-06
Package Description
6 POUCH in 1 BOX / 1 g in 1 POUCH
Product Code
42507-960
11-Digit Billing Format
42507096006
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Pain Relief Patch Lidocaine
Non-Proprietary Name
Lidocaine
Substance Name
Lidocaine
Dosage Form
Patch - A drug delivery system that often contains an adhesive backing that is usually applied to an external site on the body. Its ingredients either passively diffuse from, or are actively transported from, some portion of the patch. Depending upon the patch, the ingredients are either delivered to the outer surface of the body or into the body. A patch is sometimes synonymous with the terms ‘extended release film’ and ‘system’.
Administration Route
Topical - Administration to a particular spot on the outer surface of the body. The E2B term TRANSMAMMARY is a subset of the term TOPICAL.
Active Ingredient(s)
LIDOCAINE 4 g/100g
Pharmacologic Class
Usage Information
This product is used to help reduce itching and pain from certain skin conditions (such as scrapes, minor skin irritations, insect bites). It may also be used to help relieve nerve pain after shingles (infection with herpes zoster virus). Lidocaine belongs to a class of drugs known as local anesthetics. It works by causing a temporary loss of feeling in the area where you apply the patch.

Regulatory & Marketing

Labeler Name
Hyvee
Product Type
Human Otc Drug
FDA Application #
M017
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
11-01-2025
Listing Expiration
12-31-2026
Exclude Flag
N
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 42507-960-06 identifies a specific commercial package of 6 pouch in 1 box / 1 g in 1 pouch of Pain Relief Patch Lidocaine, a human over the counter drug labeled by Hyvee. This patch is formulated for topical use and contains lidocaine as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Hyvee on November 01, 2025. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This product is used to help reduce itching and pain from certain skin conditions (such as scrapes, minor skin irritations, insect bites). It may also be used to help relieve nerve pain after shingles (infection with herpes zoster virus). Lidocaine belongs to a class of drugs known as local anesthetics. It works by causing a temporary loss of feeling in the area where you apply the patch.

How is this Hyvee product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 42507096006. 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)
42507-960-06
11-Digit CMS (5-4-2)
42507-0960-06

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