Acne Back Chest Treatment
NDC Package 84262-012-01

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.

Acne Back Chest Treatment is spray directly onto cleansed affected areas of the back, shoulders and chest by holding 3 to 6 inches away from the skin one to three times daily.Pump works upside down for optimal application.Let dry prior to putting on clothes.Beacuase excessive drying of the skin may occur, start with one application daily, then gradually increase to two to three times daily if needed or as directed by a doctor.If bothersome dryness or peeling occurs, reduce application to once a day or every other day. Marketed by Glytone Llc, this product is identified by NDC 84262-012 and is authorized under FDA application M006.

Identification & Billing

NDC Package Code
84262-012-01
Package Description
30 mL in 1 BOTTLE, SPRAY
Product Code
84262-012
11-Digit Billing Format
84262001201

Clinical Specifications

Proprietary Name
Acne Back Chest Treatment
Dosage Form
-
Usage Information
Spray directly onto cleansed affected areas of the back, shoulders and chest by holding 3 to 6 inches away from the skin one to three times daily.Pump works upside down for optimal application.Let dry prior to putting on clothes.Beacuase excessive drying of the skin may occur, start with one application daily, then gradually increase to two to three times daily if needed or as directed by a doctor.If bothersome dryness or peeling occurs, reduce application to once a day or every other day.

Regulatory & Marketing

Labeler Name
Glytone Llc
FDA Application #
M006
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
03-01-2024
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 84262-012-01 identifies a specific commercial package of 30 ml in 1 bottle, spray of Acne Back Chest Treatment, labeled by Glytone Llc. 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 Glytone Llc on March 01, 2024. The current certification is valid through December 31, 2025.

How is this Glytone Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 84262001201. 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)
84262-012-01
11-Digit CMS (5-4-2)
84262-0012-01

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