Provon Antimicrobial Foam Handwash NDC 21749-850

NDC codes

FDA NDC Directory

Product NDC (as listed)21749-850Labeler and product segments. Claims need a package NDC.

Product NDC at billing width21749-0850Add the package segment from the table below.

Package NDCs as listed with the FDA, and the 11-digit 5-4-2 form used on claims. The highlighted digit is the added leading zero.
Package NDC	11-digit (billing)	Package	Copy
21749-850-53	21749085053	535 mL in 1 BOTTLE (21749-850-53)Marketed from May 1, 2016

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 Foam Handwash
Generic name (nonproprietary): chlorhexidine gluconate 2%
Active ingredients: Chlorhexidine gluconate — 20 mg/mL
Dosage form: Solution
Route: Topical
Labeler: Gojo Industries, Inc.
Product type: Over-the-counter drug
Marketing category: NDA — New Drug ApplicationApplication NDA 019422
Marketing start: May 1, 2016
Listing expires: Dec 31, 2026
Other FDA classes: Decreased Cell Wall Integrity (Physiologic effect)
Identifiers: Product ID 21749-850_6bf3b3cd-a681-21b6-e053-2991aa0a517aSPL ID 6bf3b3cd-a681-21b6-e053-2991aa0a517aSPL set ID 365c3ac6-6c1f-594b-e054-00144ff88e88RxCUI 1245230UNII MOR84MUD8E

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

N421749085053 followed by a unit qualifier and the quantity

Package 21749-0850-53. 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 Dec 20, 2022.

Indications (excerpt from the label)

Uses surgical hand scrub: significantly reduces the number of microorganisms on the hands and forearms prior to surgery or patient care healthcare personnel handwash: helps reduce bacteria that potentially can cause disease

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 019422

Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.

FDA NDC Directory listings under NDA 019422
Product	Strength	Form · route	Labeler	Product NDC
Antimicrobial Skin Cleanserchlorhexidine gluconate 2% solution	Chlorhexidine gluconate 20 mg/mL	LiquidTopical	Gojo Industries, Inc.	21749-106
Purell Antimicrobial Foamchlorhexidine gluconate 2% solution	Chlorhexidine gluconate 20 mg/mL	LiquidTopical	GOJO Industries, Inc.	21749-225
Purell Antimicrobial Foamchlorhexidine gluconate 2% solution	Chlorhexidine gluconate 20 mg/mL	LiquidTopical	GOJO Industries, Inc.	21749-225
Antimicrobial Foam Handwashchlorhexidine gluconate 2% solution	Chlorhexidine gluconate 20 mg/mL	LiquidTopical	GOJO Industries, Inc.	21749-416
Antiseptic Foam Handwashchlorhexidine gluconate 2% solution	Chlorhexidine gluconate 20 mg/mL	LiquidTopical	GOJO Industries, Inc.	21749-461
Dyna-Hex 2chlorhexidine gluconate	Chlorhexidine gluconate 2 g/100mL	LiquidTopical	Xttrium Laboratories, Inc.	0116-1021
Dyna-Hex 2chlorhexidine gluconate	Chlorhexidine gluconate 2 g/100mL	LiquidTopical	Xttrium Laboratories, Inc.	0116-1021
Provon Antimicrobial Foam Handwashchlorhexidine gluconate 2%	Chlorhexidine gluconate 20 mg/mL	SolutionTopical	Xttrium Laboratories, Inc.	0116-8500
Dyna-Hex 2chlorhexidine gluconate 2%	Chlorhexidine gluconate 20 mg/mL	SolutionTopical	Xttrium Laboratories, Inc.	0116-1022
Dyna-Hex 2chlorhexidine gluconate 2%	Chlorhexidine gluconate 20 mg/mL	SolutionTopical	Xttrium Laboratories, Inc.	0116-1022
Bactoshield CHG Chlorhexidine Gluconatechlorhexidine gluconate	Chlorhexidine gluconate 20 mg/mL	SolutionTopical	SC Johnson Professional USA, Inc.	11084-038
Bactoshield CHGchlorhexidine gluconate 2%	Chlorhexidine gluconate 2 mg/100mL	SolutionTopical	Xttrium Laboratories, Inc.	0116-0038
foaming hand washchlorhexidine gluconate	Chlorhexidine gluconate 20 mg/mL	LiquidTopical	Medline Industries, LP	53329-994