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  5. NDC Package Code: 84615-004-02 Pomg Pain Relief Roller

NDC Package 84615-004-02 Pomg Pain Relief Roller

Lidocaine Hydrochloride,Menthol Gel Topical - View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Find all the important details about this NDC Package code, including the 11-Digit NDC Billing number, billing units, wholesale price, RxNorm crosswalk, active ingredients, pharmacologic clasess, etc.

NDC Package Code:
84615-004-02
Package Description:
1 BOTTLE, WITH APPLICATOR in 1 CARTON / 59 mL in 1 BOTTLE, WITH APPLICATOR
Product Code:
84615-004
Proprietary Name:
Pomg Pain Relief Roller
Non-Proprietary Name:
Lidocaine Hydrochloride, Menthol
Substance Name:
Lidocaine Hydrochloride; Menthol
Usage Information:
• Adults and children 12 years of age and older:rub a thin film over desired area not more than 3 to 4 times daily• Children under 12 years of age: consult a doctor• Wash hands after use with soap and water
11-Digit NDC Billing Format:
84615000402
NDC to RxNorm Crosswalk:
  • RxCUI: 2690870 - lidocaine HCl 4 % / menthol 5 % Topical Gel
  • RxCUI: 2690870 - lidocaine hydrochloride 0.04 MG/MG / menthol 0.05 MG/MG Topical Gel
Product Type:
Human Otc Drug
Labeler Name:
Pomg Llc
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(s):
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(es):
Sample Package:
No
FDA Application Number:
M017
Marketing Category:
OTC MONOGRAPH DRUG -
Start Marketing Date:
08-14-2024
Listing Expiration Date:
12-31-2026
Exclude Flag:
N
Code Structure:

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 disclaimer below.

Other Product Packages

The following packages are also available for this product:

NDC Package CodePackage Description
84615-004-0390 mL in 1 BOTTLE, WITH APPLICATOR

* Please review the disclaimer below.

Frequently Asked Questions

What is NDC 84615-004-02?

The NDC Packaged Code 84615-004-02 is assigned to a package of 1 bottle, with applicator in 1 carton / 59 ml in 1 bottle, with applicator of Pomg Pain Relief Roller, a human over the counter drug labeled by Pomg Llc. The product's dosage form is gel and is administered via topical form.

Is NDC 84615-004 included in the NDC Directory?

Yes, Pomg Pain Relief Roller with product code 84615-004 is active and included in the NDC Directory. The product was first marketed by Pomg Llc on August 14, 2024 and its listing in the NDC Directory is set to expire on December 31, 2026 if the product is not updated or renewed by the manufacturer.

What is the 11-digit format for NDC 84615-004-02?

The 11-digit format is 84615000402. The 11-digit billing format might be required by the Centers for Medicare & Medicaid Services (CMS) and other payers in billing claim forms.

This package code is originally configured in a 5-3-2 segment 10-digit format and by adding a zero within the original NDC package code we can obtain the converted 11-digit format in a 5-4-2 segment configuration. The table below shows the 11-digit code conversion:

10-Digit Format10-Digit Original Code11-Digit Format11-Digit Code
5-3-284615-004-025-4-284615-0004-02