Gp Pbu Antimicrobial Foam Solution
NDC Package 54622-313-01

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

Package Information

Gp Pbu Antimicrobial Foam (benzalkonium chloride) solution is wet hands, apply soap, rub hands togetehr vigorously for at least 20 seconds.Rinse and dry hands thoroughly. This formulation utilizes a solution delivery system. Marketed by Georgia Pacific Consumer Products, this product is identified by NDC 54622-313 and is authorized under FDA application 505G(a)(3).

Identification & Billing

NDC Package Code
54622-313-01
Package Description
1200 mL in 1 BOTTLE, DISPENSING
Product Code
54622-313
11-Digit Billing Format
54622031301
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Gp Pbu Antimicrobial Foam
Non-Proprietary Name
Benzalkonium Chloride
Substance Name
Benzalkonium Chloride
Dosage Form
Solution - A clear, homogeneous liquid1 dosage form that contains one or more chemical substances dissolved in a solvent or mixture of mutually miscible solvents.
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)
BENZALKONIUM CHLORIDE .13 g/100mL
Usage Information
Wet hands, apply soap, rub hands togetehr vigorously for at least 20 seconds.Rinse and dry hands thoroughly.

Regulatory & Marketing

Labeler Name
Georgia Pacific Consumer Products
Product Type
Human Otc Drug
FDA Application #
505G(a)(3)
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
08-05-2021
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
Yes

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 54622-313-01 identifies a specific commercial package of 1200 ml in 1 bottle, dispensing of Gp Pbu Antimicrobial Foam, a human over the counter drug labeled by Georgia Pacific Consumer Products. This solution is formulated for topical use and contains benzalkonium chloride 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 Georgia Pacific Consumer Products on August 05, 2021. The current certification is valid through December 31, 2026.

How is this Georgia Pacific Consumer Products product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 54622031301. 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)
54622-313-01
11-Digit CMS (5-4-2)
54622-0313-01

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