White Petrolatum Jelly
NDC Package 68786-211-04

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

White Petrolatum (petrolatum) jellies is change wet and soiled diapers promptly.Cleanse the diaper area and allow to dry.Apply as needed. This formulation utilizes a jelly delivery system. Marketed by Sion Biotext Medical Ltd, this product is identified by NDC 68786-211 and is authorized under FDA application M016.

Identification & Billing

NDC Package Code
68786-211-04
Package Description
72 BOX in 1 CASE / 1 TUBE in 1 BOX / 56.7 g in 1 TUBE
Product Code
68786-211
11-Digit Billing Format
68786021104
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
White Petrolatum
Non-Proprietary Name
Petrolatum
Substance Name
Petrolatum
Dosage Form
Jelly - A class of gels, which are semisolid systems that consist of suspensions made up of either small inorganic particles or large organic molecules interpenetrated by a liquid--in which the structural coherent matrix contains a high portion of liquid, usually water.
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)
PETROLATUM 1 g/g
Usage Information
Change wet and soiled diapers promptly.Cleanse the diaper area and allow to dry.Apply as needed.

Regulatory & Marketing

Labeler Name
Sion Biotext Medical Ltd
Product Type
Human Otc Drug
FDA Application #
M016
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-16-2014
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (68786-211). Click a package code to view its specific billing and regulatory data.

68786-211-01
6 BOX in 1 CASE / 144 PACKET in 1 BOX / 5 g in 1 PACKET
68786-211-02
72 BOX in 1 CASE / 1 TUBE in 1 BOX / 28.35 g in 1 TUBE
68786-211-03
100 TUBE in 1 CASE / 28.35 g in 1 TUBE
68786-211-05
72 BOX in 1 CASE / 1 TUBE in 1 BOX / 92 g in 1 TUBE
68786-211-06
100 TUBE in 1 CASE / 92 g in 1 TUBE
68786-211-07
6 BOX in 1 CASE / 12 TUBE in 1 BOX / 113 g in 1 TUBE
68786-211-08
100 TUBE in 1 CASE / 113 g in 1 TUBE
68786-211-09
12 JAR in 1 CASE / 425 g in 1 JAR
68786-211-10
24 TUBE in 1 CASE / 284 g in 1 TUBE
68786-211-11
144 TUBE in 1 CASE / 28 g in 1 TUBE

* 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 68786-211-04 identifies a specific commercial package of 72 box in 1 case / 1 tube in 1 box / 56.7 g in 1 tube of White Petrolatum, a human over the counter drug labeled by Sion Biotext Medical Ltd. This jelly is formulated for topical use and contains petrolatum 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 Sion Biotext Medical Ltd on February 16, 2014. The current certification is valid through December 31, 2027.

How is this Sion Biotext Medical Ltd product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 68786021104. 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)
68786-211-04
11-Digit CMS (5-4-2)
68786-0211-04

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