Pain Relieving Antiseptic
NDC Package 79903-234-01

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.

Pain Relieving Antiseptic is first aid to help prevent bacterial contamination or skin infections and temporary relief of pain and itching associated with:■cuts ■scrapes ■burns ■sunburn ■skin irritationsThis product is used as. Marketed by Walmart, Inc., this product is identified by NDC 79903-234 and is authorized under FDA application M003.

Identification & Billing

NDC Package Code
79903-234-01
Package Description
148 mL in 1 BOTTLE, SPRAY
Product Code
79903-234
11-Digit Billing Format
79903023401
RxNorm Crosswalk
  • RxCUI: 2047877 - benzalkonium chloride 0.13 % / lidocaine HCl 4 % Topical Spray
  • RxCUI: 2047877 - benzalkonium chloride 1.3 MG/ML / lidocaine hydrochloride 40 MG/ML Topical Spray

Clinical Specifications

Proprietary Name
Pain Relieving Antiseptic
Dosage Form
-
Usage Information
First aid to help prevent bacterial contamination or skin infections and temporary relief of pain and itching associated with:■cuts ■scrapes ■burns ■sunburn ■skin irritationsThis product is used as . First aid to help prevent bacterial contamination or skin infections, and temporary relief of pain and itching associated with minor: ■cuts ■scrapes ■burns ■sunburn ■skin irritations.

Regulatory & Marketing

Labeler Name
Walmart, Inc.
FDA Application #
M003
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-29-2024
Listing Expiration
12-31-2025
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 79903-234-01 identifies a specific commercial package of 148 ml in 1 bottle, spray of Pain Relieving Antiseptic, labeled by Walmart, 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 Walmart, Inc. on February 29, 2024. The current certification is valid through December 31, 2025.

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

For medical billing and reimbursement, this package follows the 11-digit CMS format: 79903023401. 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)
79903-234-01
11-Digit CMS (5-4-2)
79903-0234-01

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