The Pharma C Company Medicated Foam With Witch Hazel Liquid
NDC Package 55239-358-00

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

Package Information

The Pharma C Company Medicated Foam With Witch Hazel (witch hazel) liquids is adults:   when practical, clean the affected area with mild soap and warm water and rinse thoroughlygently dry area by patting or blotting with toilet tissure or a soft clothpump a small amount of foam onto clean toilet paper and apply externally to the affected areaafter application, flush toilet paper and wash handsmedicated foam may be used up to 6 times daily or after each bowel movement Children under 12 years of age: ask a doctor. This formulation utilizes a liquid delivery system. Marketed by Kleen Test Products Corporation, this product is identified by NDC 55239-358 and is authorized under FDA application M015.

Identification & Billing

NDC Package Code
55239-358-00
Package Description
210 mL in 1 BOTTLE
Product Code
55239-358
11-Digit Billing Format
55239035800
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
The Pharma C Company Medicated Foam With Witch Hazel
Non-Proprietary Name
Witch Hazel
Substance Name
Witch Hazel
Dosage Form
Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
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)
WITCH HAZEL 500 mg/mL
Usage Information
Adults:   when practical, clean the affected area with mild soap and warm water and rinse thoroughlygently dry area by patting or blotting with toilet tissure or a soft clothpump a small amount of foam onto clean toilet paper and apply externally to the affected areaafter application, flush toilet paper and wash handsmedicated foam may be used up to 6 times daily or after each bowel movement Children under 12 years of age: ask a doctor

Regulatory & Marketing

Labeler Name
Kleen Test Products Corporation
Product Type
Human Otc Drug
FDA Application #
M015
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
05-15-2022
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 55239-358-00 identifies a specific commercial package of 210 ml in 1 bottle of The Pharma C Company Medicated Foam With Witch Hazel, a human over the counter drug labeled by Kleen Test Products Corporation. This liquid is formulated for topical use and contains witch hazel 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 Kleen Test Products Corporation on May 15, 2022. The current certification is valid through December 31, 2026.

How is this Kleen Test Products Corporation product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 55239035800. 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)
55239-358-00
11-Digit CMS (5-4-2)
55239-0358-00

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