Percara Oral Health Rinse
NDC Package 67933-0321-1

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

Package Information

Percara Oral Health Rinse (cetylpyridinium chloride) rinses is use helps control plaque that leads to gingivitis. This formulation utilizes a rinse delivery system. Marketed by Lec Custom Products, Inc, this product is identified by NDC 67933-0321 and is authorized under FDA application M021.

Identification & Billing

NDC Package Code
67933-0321-1
Package Description
500 mL in 1 BOTTLE, PLASTIC
Product Code
67933-0321
11-Digit Billing Format
67933032101
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Percara Oral Health Rinse Fresh Mint
Non-Proprietary Name
Cetylpyridinium Chloride
Substance Name
Cetylpyridinium Chloride
Dosage Form
Rinse - A liquid used to cleanse by flushing.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
CETYLPYRIDINIUM CHLORIDE .07 g/100mL
Usage Information
Use helps control plaque that leads to gingivitis.

Regulatory & Marketing

Labeler Name
Lec Custom Products, Inc
Product Type
Human Otc Drug
FDA Application #
M021
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-15-2021
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 67933-0321-1 identifies a specific commercial package of 500 ml in 1 bottle, plastic of Percara Oral Health Rinse Fresh Mint, a human over the counter drug labeled by Lec Custom Products, Inc. This rinse is formulated for oral use and contains cetylpyridinium chloride 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 Lec Custom Products, Inc on March 15, 2021. The current certification is valid through December 31, 2026.

How is this Lec Custom Products, Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 67933032101. 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 (5-4-1)
67933-0321-1
11-Digit CMS (5-4-2)
67933-0321-01

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