Lidopro Patch (lidocaine 4%, Menthol 1%) Patch
NDC Package 83881-402-05

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

Lidopro Patch (lidocaine 4%, Menthol 1%) (lidocaine and menthol patch) patches is adults 18 years and older:clean and dry affected areaopen pouch and remove one patchremove protective film from patchapply one patch to the affected area of pain and leave in place for 8 to 12 hours. This formulation utilizes a patch delivery system. Marketed by Clinic Pharma, this product is identified by NDC 83881-402 and is authorized under FDA application M017.

Identification & Billing

NDC Package Code
83881-402-05
Package Description
5 mg in 1 POUCH
Product Code
83881-402
11-Digit Billing Format
83881040205
RxNorm Crosswalk
  • RxCUI: 1249758 - lidocaine 4 % / menthol 1 % Medicated Patch
  • RxCUI: 1249758 - lidocaine 0.04 MG/MG / menthol 0.01 MG/MG Medicated Patch
  • RxCUI: 2675625 - LidoPro Pain Relieving Patch 4 % / 1 % Medicated Patch
  • RxCUI: 2675625 - lidocaine 0.04 MG/MG / menthol 0.01 MG/MG Medicated Patch [LidoPro Pain Relieving Patch]
  • RxCUI: 2675625 - LidoPro Pain Relieving Patch (lidocaine 4 % / menthol 1 % ) Medicated Patch

Clinical Specifications

Proprietary Name
Lidopro Patch (lidocaine 4%, Menthol 1%)
Non-Proprietary Name
Lidocaine And Menthol Patch
Substance Name
Lidocaine; Menthol
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
Transdermal - Administration through the dermal layer of the skin to the systemic circulation by diffusion.
Active Ingredient(s)
Pharmacologic Class
Usage Information
Adults 18 years and older:clean and dry affected areaopen pouch and remove one patchremove protective film from patchapply one patch to the affected area of pain and leave in place for 8 to 12 hours

Regulatory & Marketing

Labeler Name
Clinic Pharma
Product Type
Human Otc Drug
FDA Application #
M017
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
01-09-2025
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 (83881-402). Click a package code to view its specific billing and regulatory data.

83881-402-15
15 mg in 1 POUCH

* 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 83881-402-05 identifies a specific commercial package of 5 mg in 1 pouch of Lidopro Patch (lidocaine 4%, Menthol 1%), a human over the counter drug labeled by Clinic Pharma. This patch is formulated for transdermal use and contains lidocaine; menthol 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 Clinic Pharma on January 09, 2025. The current certification is valid through December 31, 2026.

How is this Clinic Pharma product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 83881040205. 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)
83881-402-05
11-Digit CMS (5-4-2)
83881-0402-05

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