Over-the-counter drug · OTC MONOGRAPH DRUG
PROVON Antimicrobial Ltn Sp with 0.3% PCMX (Chloroxylenol) NDC 21749-750
Chloroxylenol .003 mg/mL · Liquid · Topical · GOJO Industries, Inc.
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 21749-750-04 | 2174907500421749075004 | 118 mL in 1 BOTTLE (21749-750-04)Marketed from Aug 31, 2013 | |
| 21749-750-10 | 2174907501021749075010 | 1000 mL in 1 BAG (21749-750-10)Marketed from Aug 31, 2013 | |
| 21749-750-16 | 2174907501621749075016 | 473 mL in 1 BOTTLE (21749-750-16)Marketed from Aug 31, 2013 |
How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 5-4-2). Formatting the NDC does not by itself make it billable — the product, package and quantity must match what was dispensed or administered, and payer rules apply. Conversion rules
Product information
- Brand name (proprietary)
- PROVON Antimicrobial Ltn Sp with 0.3% PCMX
- Generic name (nonproprietary)
- chloroxylenol
- Active ingredients
- Chloroxylenol — .003 mg/mL
- Dosage form
- Liquid
- Route
- Topical
- Labeler
- GOJO Industries, Inc.NDC labeler code 21749
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication 505G(a)(3)
- Marketing start
- Listing expires
- Identifiers
- Product ID 21749-750_4c38ea89-7cb8-a37a-e063-6394a90a5ebdSPL ID 4c38ea89-7cb8-a37a-e063-6394a90a5ebdSPL set ID d9dfd7fe-6a24-4815-a9c8-4c45b4bf65b3UNII 0F32U78V2Q
Billing references
What Med-Code can say about coding this product, and where each statement comes from. Nothing here is inferred from the name alone.
- HCPCS codeNo match
No HCPCS code in Med-Code's directory. Topical products like this are usually dispensed by a pharmacy and billed by NDC.
- NDC on a medical claim
N421749075004followed by a unit qualifier and the quantityPackage 21749-0750-04. Unit qualifiers: F2 (international unit), GR (gram), ME (milligram), ML (milliliter), UN (unit (each)). The qualifier and quantity depend on what was given. About the N4 qualifier
Product label
Current FDA label (SPL), effective .
Indications (excerpt from the label)
Use • Handwash to help decrease bacteria on the skin • Recommended for repeated use
Excerpt only. Read the full label for complete information.
About NDC 21749-750
- What is NDC 21749-750?
- 21749-750 is the product NDC for PROVON Antimicrobial Ltn Sp with 0.3% PCMX, Chloroxylenol .003 mg/mL liquid, listed with the FDA by GOJO Industries, Inc.. It has 3 package NDCs, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- PROVON Antimicrobial Ltn Sp with 0.3% PCMX (Chloroxylenol).
- What is the active ingredient?
- Chloroxylenol.
- Who is the labeler?
- GOJO Industries, Inc., NDC labeler code 21749. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for PROVON Antimicrobial Ltn Sp with 0.3% PCMX?
- None: this is the only finished product listed under this name.
- Is there a related HCPCS / J-code?
- Not in Med-Code's curated HCPCS directory. See Billing references above.
Other NDCs under 505G(a)(3)
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
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