Isopropyl Alcohol Prep Pad Sterile
NDC Package 69789-104-02

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 inactivated by the FDA.

Isopropyl Alcohol Prep Pad Sterile is directions Tear open individual swab and apply product to the injection site prior to an injection.Rub skin briskly in circular motion from injection site outward. Marketed by Lsl Industries Inc, this product is identified by NDC 69789-104 and is authorized under FDA application part333A.

Identification & Billing

NDC Package Code
69789-104-02
Package Description
200 PACKET in 1 BOX / .238 mL in 1 PACKET
Product Code
69789-104
11-Digit Billing Format
69789010402
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Isopropyl Alcohol Prep Pad Sterile
Dosage Form
-
Usage Information
Directions Tear open individual swab and apply product to the injection site prior to an injection.Rub skin briskly in circular motion from injection site outward

Regulatory & Marketing

Labeler Name
Lsl Industries Inc
FDA Application #
part333A
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
05-14-2015
Listing Expiration
12-31-2017
Exclude Flag
I
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 69789-104-02 identifies a specific commercial package of 200 packet in 1 box / .238 ml in 1 packet of Isopropyl Alcohol Prep Pad Sterile, labeled by Lsl Industries 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 Lsl Industries Inc on May 14, 2015. The current certification is valid through December 31, 2017.

How is this Lsl Industries Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69789010402. 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)
69789-104-02
11-Digit CMS (5-4-2)
69789-0104-02

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