Hydrogen Peroxide Spray
NDC Package 67777-015-07

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

Package Information

Hydrogen Peroxide (1169 hydrogen peroxide spray) sprays is • Spray over affected area • May be covered with a sterile bandage • If bandaged, let dry first• Children under 12 years of age: Consult a doctor before use. This formulation utilizes a spray delivery system. Marketed by Dynarex Corporation, this product is identified by NDC 67777-015 and is authorized under FDA application M003.

Identification & Billing

NDC Package Code
67777-015-07
Package Description
24 BOTTLE, SPRAY in 1 CASE / 59.1 mL in 1 BOTTLE, SPRAY (67777-015-08)
Product Code
67777-015
11-Digit Billing Format
67777001507

Clinical Specifications

Proprietary Name
Hydrogen Peroxide
Non-Proprietary Name
1169 Hydrogen Peroxide Spray
Substance Name
Hydrogen Peroxide
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)
HYDROGEN PEROXIDE .03 mg/mL
Usage Information
• Spray over affected area • May be covered with a sterile bandage • If bandaged, let dry first• Children under 12 years of age: Consult a doctor before use

Regulatory & Marketing

Labeler Name
Dynarex Corporation
Product Type
Human Otc Drug
FDA Application #
M003
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-29-2024
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (67777-015). Click a package code to view its specific billing and regulatory data.

67777-015-05
1000 PACKET in 1 CASE / 29.6 mL in 1 PACKET (67777-015-06)

* 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 67777-015-07 identifies a specific commercial package of 24 bottle, spray in 1 case / 59.1 ml in 1 bottle, spray (67777-015-08) of Hydrogen Peroxide, a human over the counter drug labeled by Dynarex Corporation. This spray is formulated for topical use and contains hydrogen peroxide 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 Dynarex Corporation on February 29, 2024. The current certification is valid through December 31, 2026.

How is this Dynarex Corporation product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 67777001507. 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)
67777-015-07
11-Digit CMS (5-4-2)
67777-0015-07

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