Glycerin, Lidocaine, Petrolatum, And Phenylephrine Hydrochloride
NDC Package 55629-051-04

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.

Glycerin, Lidocaine, Petrolatum, And Phenylephrine Hydrochloride is adults: when practical, cleanse the affected area by patting or blotting with an appropriate cleansing wipe. Marketed by One2zee Limited Liability Company, this product is identified by NDC 55629-051 and is authorized under FDA application part346.

Identification & Billing

NDC Package Code
55629-051-04
Package Description
1 TUBE in 1 CARTON / 113 g in 1 TUBE
Product Code
55629-051
11-Digit Billing Format
55629005104
RxNorm Crosswalk
  • RxCUI: 2642220 - glycerin 14.4 % / lidocaine 5 % / phenylephrine HCl 0.25 % / white petrolatum 15 % Rectal Cream
  • RxCUI: 2642220 - glycerin 144 MG/ML / lidocaine 50 MG/ML / petrolatum 150 MG/ML / phenylephrine hydrochloride 2.5 MG/ML Rectal Cream

Clinical Specifications

Proprietary Name
Glycerin, Lidocaine, Petrolatum, And Phenylephrine Hydrochloride
Dosage Form
-
Usage Information
Adults: when practical, cleanse the affected area by patting or blotting with an appropriate cleansing wipe. Gently dry by patting or blotting with a tissue or a soft cloth before applying this cream.Apply externally to the affected area up to 4 times daily, especially at night, in the morning or after each bowel movementChildren under 12 years of age: ask a doctor

Regulatory & Marketing

Labeler Name
One2zee Limited Liability Company
FDA Application #
part346
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
02-08-2021
Listing Expiration
12-31-2022
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 55629-051-04 identifies a specific commercial package of 1 tube in 1 carton / 113 g in 1 tube of Glycerin, Lidocaine, Petrolatum, And Phenylephrine Hydrochloride, labeled by One2zee Limited Liability Company. 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 One2zee Limited Liability Company on February 08, 2021. The current certification is valid through December 31, 2022.

How is this One2zee Limited Liability Company product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 55629005104. 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)
55629-051-04
11-Digit CMS (5-4-2)
55629-0051-04

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