Cvs Advance Acne Therapy Kit
NDC Package 42877-003-01

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 discontinued by the firm.

Cvs Advance Acne Therapy Kit is a . Marketed by Diversified Global Technologies, Llc, this product is identified by NDC 42877-003 and is authorized under FDA application part333D.

Identification & Billing

NDC Package Code
42877-003-01
Package Description
1 KIT in 1 KIT * 12 mL in 1 TUBE (42877-005-12) * 22 mL in 1 TUBE (42877-006-22) * 118 mL in 1 TUBE (42877-004-04)
Product Code
42877-003
11-Digit Billing Format
42877000301

Clinical Specifications

Proprietary Name
Cvs Advance Acne Therapy Kit
Dosage Form
-

Regulatory & Marketing

Labeler Name
Diversified Global Technologies, Llc
FDA Application #
part333D
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
01-18-2017
End Marketing Date
06-11-2020
Listing Expiration
06-11-2020
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 42877-003-01 identifies a specific commercial package of 1 kit in 1 kit * 12 ml in 1 tube (42877-005-12) * 22 ml in 1 tube (42877-006-22) * 118 ml in 1 tube (42877-004-04) of Cvs Advance Acne Therapy Kit, labeled by Diversified Global Technologies, Llc. 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 Diversified Global Technologies, Llc on January 18, 2017. The current certification is valid through June 11, 2020.

How is this Diversified Global Technologies, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 42877000301. 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)
42877-003-01
11-Digit CMS (5-4-2)
42877-0003-01

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