Granulotion Skin Protectant
NDC Package 65121-355-02

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.

Granulotion Skin Protectant is a . Marketed by Pure Source Inc, this product is identified by NDC 65121-355 and is authorized under FDA application part347.

Identification & Billing

NDC Package Code
65121-355-02
Package Description
56.6 g in 1 JAR
Product Code
65121-355
11-Digit Billing Format
65121035502

Clinical Specifications

Proprietary Name
Granulotion Skin Protectant
Dosage Form
-

Regulatory & Marketing

Labeler Name
Pure Source Inc
FDA Application #
part347
Marketing Category
OTC MONOGRAPH FINAL - A product marketed pursuant to a final Over-the-Counter (OTC) Drug Monograph.
Start Marketing Date
10-09-2013
End Marketing Date
04-16-2014
Listing Expiration
04-16-2014
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 65121-355-02 identifies a specific commercial package of 56.6 g in 1 jar of Granulotion Skin Protectant, labeled by Pure Source Inc. 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 Pure Source Inc on October 09, 2013. The current certification is valid through April 16, 2014.

How is this Pure Source Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 65121035502. 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)
65121-355-02
11-Digit CMS (5-4-2)
65121-0355-02

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