Witch Hazel Spray
NDC Package 59779-765-17

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

Package Information

Witch Hazel (witch hazel spray) sprays is apply as often as neededto apply to face, moisten cotton ball or cleansing pad and gently wipe skin. This formulation utilizes a spray delivery system. Marketed by Cvs Pharmacy, this product is identified by NDC 59779-765 and is authorized under FDA application M016.

Identification & Billing

NDC Package Code
59779-765-17
Package Description
170 g in 1 CAN
Product Code
59779-765
11-Digit Billing Format
59779076517
Billing Unit
GM - Billing unit of "gram" is used when a product is measured by its weight.
Units Per Package
170 GM
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Witch Hazel
Non-Proprietary Name
Witch Hazel Spray
Substance Name
Witch Hazel
Dosage Form
Spray - A liquid minutely divided as by a jet of air or steam.
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 146 g/170g
Usage Information
Apply as often as neededto apply to face, moisten cotton ball or cleansing pad and gently wipe skin

Regulatory & Marketing

Labeler Name
Cvs Pharmacy
Product Type
Human Otc Drug
FDA Application #
M016
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-01-2017
Listing Expiration
12-31-2027
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 59779-765-17 identifies a specific commercial package of 170 g in 1 can of Witch Hazel, a human over the counter drug labeled by Cvs Pharmacy. This product is billed per "GM" gram and contains an estimated amount of 170 billable units per package. This spray 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 Cvs Pharmacy on March 01, 2017. The current certification is valid through December 31, 2027.

How is this Cvs Pharmacy product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 59779076517. Quantities are measured in per "gm or gram", products billed per gram are products measured by weight.. There are 170 total billable units per package. 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)
59779-765-17
11-Digit CMS (5-4-2)
59779-0765-17

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