Lidocaine Pain Relief Patch
NDC Package 69159-920-05

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

Package Information

Lidocaine Pain Relief Patch (lidocaine and menthol, unspecified form) patches is adults and children over 12 years of age:clean and dry affected areastrip off the clear protective film and place adhesive patch over affected arealeave in place for up to 8 hourswash hands thoroughly after applying or removing patch.Children under 12 years: ask a doctor before use. This formulation utilizes a patch delivery system. Marketed by Foshan Aqua Gel Biotech Co.,ltd., this product is identified by NDC 69159-920 and is authorized under FDA application part348.

Identification & Billing

NDC Package Code
69159-920-05
Package Description
1 POUCH in 1 CARTON / 5 PATCH in 1 POUCH / 9 g in 1 PATCH
Product Code
69159-920
11-Digit Billing Format
69159092005
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Lidocaine Pain Relief Patch
Non-Proprietary Name
Lidocaine And Menthol, Unspecified Form
Substance Name
Lidocaine; Menthol, Unspecified Form
Dosage Form
Patch - A drug delivery system that often contains an adhesive backing that is usually applied to an external site on the body. Its ingredients either passively diffuse from, or are actively transported from, some portion of the patch. Depending upon the patch, the ingredients are either delivered to the outer surface of the body or into the body. A patch is sometimes synonymous with the terms ‘extended release film’ and ‘system’.
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)
Pharmacologic Class
Usage Information
Adults and children over 12 years of age:clean and dry affected areastrip off the clear protective film and place adhesive patch over affected arealeave in place for up to 8 hourswash hands thoroughly after applying or removing patch.Children under 12 years: ask a doctor before use.

Regulatory & Marketing

Labeler Name
Foshan Aqua Gel Biotech Co.,ltd.
Product Type
Human Otc Drug
FDA Application #
part348
Marketing Category
OTC MONOGRAPH NOT FINAL - A product marketed pursuant to an Over-the-Counter (OTC) Drug Monograph that is not final.
Start Marketing Date
09-01-2016
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 69159-920-05 identifies a specific commercial package of 1 pouch in 1 carton / 5 patch in 1 pouch / 9 g in 1 patch of Lidocaine Pain Relief Patch, a human over the counter drug labeled by Foshan Aqua Gel Biotech Co.,ltd.. This patch is formulated for topical use and contains lidocaine; menthol, unspecified form 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 Foshan Aqua Gel Biotech Co.,ltd. on September 01, 2016. The current certification is valid through December 31, 2026.

How is this Foshan Aqua Gel Biotech Co.,ltd. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69159092005. 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)
69159-920-05
11-Digit CMS (5-4-2)
69159-0920-05

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