Ultra Violette Spf Mini Mates Duo Pocket Pals Lotion
NDC Package 84803-112-01

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Ultra Violette Spf Mini Mates Duo Pocket Pals (active ingredients supreme screen spf 50 avobenzone 3% homosalate 7% octisalate 5% octocrylene 8% active ingredients future screen spf 50 zinc oxide 20%) lotions is hELPS PREVENT SUNBURNIf used as directed with other sun protection measures (see Directions), decreases the risk of skin cancer and early skin aging caused by the sun. This formulation utilizes a lotion delivery system. Marketed by Grace And Fire Usa Inc., this product is identified by NDC 84803-112 and is authorized under FDA application M020.

Identification & Billing

NDC Package Code
84803-112-01
Package Description
40 mL in 1 CARTON
Product Code
84803-112
11-Digit Billing Format
84803011201

Clinical Specifications

Proprietary Name
Ultra Violette Spf Mini Mates Duo Pocket Pals Ultra Violette Spf Mini Mates Duo Pocket Pals Contains 1 X Supreme Screen Spf50 20ml (84803-100-21) 1 X Future Screen Spf50 20ml (84803-103-21)
Non-Proprietary Name
Active Ingredients Supreme Screen Spf 50 Avobenzone 3% Homosalate 7% Octisalate 5% Octocrylene 8% Active Ingredients Future Screen Spf 50 Zinc Oxide 20%
Substance Name
Avobenzone; Homosalate; Octisalate; Octocrylene; Zinc Oxide
Dosage Form
Lotion - An emulsion, liquid1 dosage form. This dosage form is generally for external application to the skin.2
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)
Usage Information
HELPS PREVENT SUNBURNIf used as directed with other sun protection measures (see Directions), decreases the risk of skin cancer and early skin aging caused by the sun

Regulatory & Marketing

Labeler Name
Grace And Fire Usa Inc.
Product Type
Human Otc Drug
FDA Application #
M020
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
01-19-2026
Listing Expiration
12-31-2027
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 84803-112-01 identifies a specific commercial package of 40 ml in 1 carton of Ultra Violette Spf Mini Mates Duo Pocket Pals Ultra Violette Spf Mini Mates Duo Pocket Pals Contains 1 X Supreme Screen Spf50 20ml (84803-100-21) 1 X Future Screen Spf50 20ml (84803-103-21), a human over the counter drug labeled by Grace And Fire Usa Inc.. This lotion is formulated for topical use and contains avobenzone; homosalate; octisalate; octocrylene; zinc oxide 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 Grace And Fire Usa Inc. on January 19, 2026. The current certification is valid through December 31, 2027.

How is this Grace And Fire Usa Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 84803011201. 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)
84803-112-01
11-Digit CMS (5-4-2)
84803-0112-01

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