Bulpol Smoking Patches Liquid
NDC Package 84867-017-01

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

Package Information

Bulpol Smoking Patches (menthol) liquids is ifyou smoke 10 orless cigarettes per day, do not useSTEP 1 (21 mg). This formulation utilizes a liquid delivery system. Marketed by Jiashen International Trade Limited, this product is identified by NDC 84867-017 and is authorized under FDA application M012.

Identification & Billing

NDC Package Code
84867-017-01
Package Description
30 PATCH in 1 BOX / 10 g in 1 PATCH
Product Code
84867-017
11-Digit Billing Format
84867001701

Clinical Specifications

Proprietary Name
Bulpol Smoking Patches
Non-Proprietary Name
Menthol
Substance Name
Menthol
Dosage Form
Liquid - A dosage form consisting of a pure chemical in its liquid1 state. This dosage form term should not be applied to solutions.
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)
MENTHOL 21 mg/g
Usage Information
Ifyou smoke 10 orless cigarettes per day, do not useSTEP 1 (21 mg). Start with STEP 2 (14 mg) for 6 weeks,then STEP 3 (7 mg) for 2 weeks and then stop.steps 2 and 3 allow you to gradually reduce yourlevel ofnicotine.Completingthe full program willincrease yourchances ofquittingsuccessfully.apply one new patch every 24 hours on skin that is dry, cleanand hairless. Save pouch for disposingofthe patch after use.remove backingfrom patch andimmediately press onto skin.Hold for 10 seconds.

Regulatory & Marketing

Labeler Name
Jiashen International Trade Limited
Product Type
Human Otc Drug
FDA Application #
M012
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
07-17-2025
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 84867-017-01 identifies a specific commercial package of 30 patch in 1 box / 10 g in 1 patch of Bulpol Smoking Patches, a human over the counter drug labeled by Jiashen International Trade Limited. This liquid is formulated for topical use and contains 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 Jiashen International Trade Limited on July 17, 2025. The current certification is valid through December 31, 2026.

How is this Jiashen International Trade Limited product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 84867001701. 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)
84867-017-01
11-Digit CMS (5-4-2)
84867-0017-01

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