Forticept Wounds And Burns Hydrogel
NDC Package 72127-0803-1

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

Forticept Wounds And Burns Hydrogel (benzethonium chloride, lidocaine hydrochloride) gel is topical analgesic - for temporary relief of pain or discomfort for superficial and full thickness burns or wounds.Topical antiseptic - to help decrease the risk of wounf and skin infections. This formulation utilizes a gel delivery system. Marketed by Lidan, Inc., this product is identified by NDC 72127-0803 and is authorized under FDA application M017.

Identification & Billing

NDC Package Code
72127-0803-1
Package Description
.085 kg in 1 TUBE
Product Code
72127-0803
11-Digit Billing Format
72127080301

Clinical Specifications

Proprietary Name
Forticept Wounds And Burns Hydrogel
Non-Proprietary Name
Benzethonium Chloride, Lidocaine Hydrochloride
Substance Name
Benzethonium Chloride; Lidocaine
Dosage Form
Gel - A semisolid3 dosage form that contains a gelling agent to provide stiffness to a solution or a colloidal dispersion.4 A gel may contain suspended particles.
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
Topical analgesic - for temporary relief of pain or discomfort for superficial and full thickness burns or wounds.Topical antiseptic - to help decrease the risk of wounf and skin infections.

Regulatory & Marketing

Labeler Name
Lidan, Inc.
Product Type
Human Otc Drug
FDA Application #
M017
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
05-06-2020
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 (72127-0803). Click a package code to view its specific billing and regulatory data.

72127-0803-0
.114 kg 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 72127-0803-1 identifies a specific commercial package of .085 kg in 1 tube of Forticept Wounds And Burns Hydrogel, a human over the counter drug labeled by Lidan, Inc.. This gel is formulated for topical use and contains benzethonium chloride; lidocaine 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 Lidan, Inc. on May 06, 2020. The current certification is valid through December 31, 2026.

How is this Lidan, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72127080301. 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)
72127-0803-1
11-Digit CMS (5-4-2)
72127-0803-01

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