Tesalova Coconut Spf 30 Lip Balm Stick
NDC Package 87906-172-01

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

Package Information

Tesalova Coconut Spf 30 Lip Balm (avobenzone, octinoxate, octisalate, oxybenzone) sticks is usehelps prevent sunburn. This formulation utilizes a stick delivery system. Marketed by Tesalova Viktoriia Pmu Llc, this product is identified by NDC 87906-172 and is authorized under FDA application M020.

Identification & Billing

NDC Package Code
87906-172-01
Package Description
4.25 g in 1 TUBE
Product Code
87906-172
11-Digit Billing Format
87906017201

Clinical Specifications

Proprietary Name
Tesalova Coconut Spf 30 Lip Balm Spf 30
Non-Proprietary Name
Avobenzone, Octinoxate, Octisalate, Oxybenzone
Substance Name
Octinoxate; Oxybenzone; Avobenzone; Octisalate
Dosage Form
Stick - A dosage form prepared in a relatively long and slender often cylindrical form.
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
Usehelps prevent sunburn

Regulatory & Marketing

Labeler Name
Tesalova Viktoriia Pmu Llc
Product Type
Human Otc Drug
FDA Application #
M020
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
08-19-2026
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 87906-172-01 identifies a specific commercial package of 4.25 g in 1 tube of Tesalova Coconut Spf 30 Lip Balm Spf 30, a human over the counter drug labeled by Tesalova Viktoriia Pmu Llc. This stick is formulated for topical use and contains octinoxate; oxybenzone; avobenzone; octisalate 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 Tesalova Viktoriia Pmu Llc on August 19, 2026. The current certification is valid through December 31, 2027.

How is this Tesalova Viktoriia Pmu Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 87906017201. 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)
87906-172-01
11-Digit CMS (5-4-2)
87906-0172-01

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