Menthol Pain Relief Patches Patch
NDC Package 84876-005-01

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

Package Information

Menthol Pain Relief Patches (menthol) patches is i adults and children 12 years of age and older: Clean and dry affected area, pop apartand partiallypeel back protective film and apply exposed patch to site of pain. This formulation utilizes a patch delivery system. Marketed by Menthol Pain Relief Patch, this product is identified by NDC 84876-005 and is authorized under FDA application M017.

Identification & Billing

NDC Package Code
84876-005-01
Package Description
6 PATCH in 1 BOX / 6.6 g in 1 PATCH
Product Code
84876-005
11-Digit Billing Format
84876000501
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Menthol Pain Relief Patches
Non-Proprietary Name
Menthol
Substance Name
Capsaicin; 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
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
I adults and children 12 years of age and older: Clean and dry affected area, pop apartand partiallypeel back protective film and apply exposed patch to site of pain. Carefullyremove remaining filmwhile pressing the patch to skin and leave in place for up to 8hours. Use on affected area not morethan 3 to 4 times daily.children under 12 years of age: consult a physicianwash hands after use with cool water

Regulatory & Marketing

Labeler Name
Menthol Pain Relief Patch
Product Type
Human Otc Drug
FDA Application #
M017
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
08-01-2025
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 84876-005-01 identifies a specific commercial package of 6 patch in 1 box / 6.6 g in 1 patch of Menthol Pain Relief Patches, a human over the counter drug labeled by Menthol Pain Relief Patch. This patch is formulated for topical use and contains capsaicin; 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 Menthol Pain Relief Patch on August 01, 2025. The current certification is valid through December 31, 2026.

How is this Menthol Pain Relief Patch product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 84876000501. 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)
84876-005-01
11-Digit CMS (5-4-2)
84876-0005-01

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