Tripleantibioticointmentandpainrelief NDC 69396-030

NDC codes

FDA NDC Directory

Product NDC (as listed)69396-030Labeler and product segments. Claims need a package NDC.

Product NDC at billing width69396-0030Add 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
69396-030-01	69396003001	1 TUBE in 1 BOX (69396-030-01) / 28.4 g in 1 TUBEMarketed from Jul 20, 2017
69396-030-44	69396003044	4 TUBE in 1 BOX (69396-030-44) / 30 g in 1 TUBEMarketed from Oct 20, 2024

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): Tripleantibioticointmentandpainrelief
Generic name (nonproprietary): bacitracin,neomycin,polymxin, pramoxine
Active ingredients: Bacitracin — 500 [USP'U]/100gNeomycin sulfate — 3.5 mg/100gPramoxine hydrochloride — 10 mg/100gPolymyxin b sulfate — 10000 [USP'U]/100g
Dosage form: Ointment
Route: Topical
Labeler: Trifecta Pharmaceuticals USA
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 004
Marketing start: Jul 20, 2017
Listing expires: Dec 31, 2026
Other FDA classes: Aminoglycosides (Chemical structure)Decreased Cell Wall Synthesis & Repair (Physiologic effect)Polymyxins (Chemical structure)
Identifiers: Product ID 69396-030_41c15d67-44b6-5c87-e063-6294a90adcc8SPL ID 41c15d67-44b6-5c87-e063-6294a90adcc8SPL set ID 54c1d306-dc3b-2885-e054-00144ff8d46cRxCUI 1359350UNII 58H6RWO52I, 057Y626693, 88AYB867L5, 19371312D4UPC 0040232381461, 0040232622687
Pharmacologic class: Aminoglycoside Antibacterial; Polymyxin-class Antibacterial

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

N469396003001 followed by a unit qualifier and the quantity

Package 69396-0030-01. 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 Oct 22, 2025.

Indications (excerpt from the label)

Uses First Aid to help prevent infection in minor: Cuts Scrapes Burns

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under M 004

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

FDA NDC Directory listings under M 004
Product	Strength	Form · route	Labeler	Product NDC
Premier Value Triple Antibioticbacitracin zinc, neomycin sulfate, polymyxin b sulfate	Bacitracin zinc 400 [USP'U]/g + 2 more ingredients	OintmentTopical	Premier Value Alliance LLC.	68016-320
Hydrogen Peroxide	Hydrogen peroxide 30 mg/mL	SprayTopical	JHK Inc	73598-0661
antibiotic plus pain reliefneomycin, polymyxin b, pramoxine hydrochloride	Neomycin sulfate 3.5 mg/g + 2 more ingredients	CreamTopical	Kroger Company	30142-790
Triple Antibioticbacitracin zinc, neomycin, polymyxin b	Bacitracin zinc 400 [USP'U]/g + 2 more ingredients	OintmentTopical	A-S Medication Solutions	50090-1859
Family Wellness Antiseptic and Pain Reliefbacitracin zinc, neomycin sulfate, polymyxin b sulfate, pramoxine hydrochloride	Bacitracin zinc .51 g/100g + 3 more ingredients	OintmentTopical	FRONT PHARMACEUTICAL PLC	69571-007
Triple Antibioticbacitracin zinc, neomycin sulfate, polymyxin b sulfate	Bacitracin zinc 400 [USP'U]/g + 2 more ingredients	OintmentTopical	Premier Value Alliance LLC.	68016-319
Family Wellnessbacitracin zinc	Bacitracin zinc .51 g/100g	OintmentTopical	FRONT PHARMACEUTICAL PLC	69571-008
Basic Care First Aid Antibioticbacitracin, neomycin, polymyxin b, pramoxine hcl	Bacitracin zinc 500 [USP'U]/g + 3 more ingredients	OintmentTopical	Amazon.com Services LLC	72288-679
Isopropyl Alcohol	Isopropyl alcohol 700 mL/L	SprayTopical	JHK Inc	73598-0651
Single Antibioticbacitracin zinc	Bacitracin zinc 500 [iU]/g	OintmentTopical	Safetec of America, Inc.	61010-4404
Signature Care Triple Antibioticbacitracin, neomycin, polymyxin b, pramoxine hcl	Bacitracin zinc 500 [USP'U]/g + 3 more ingredients	OintmentTopical	Safeway	21130-448
Triple Antibiotic with Pain Reliefbacitracin zinc, neomycin sulfate, polymyxin b sulfate, pramoxine hydrochloride	Bacitracin zinc 500 [iU]/g + 3 more ingredients	OintmentTopical	Safetec of America, Inc.	61010-4401
Fresh Startchloroxylenol	Chloroxylenol 3 mg/mL	SoapTopical	Pro Chem, Inc.	63830-950
Family Care First Aidbacitracin zinc	Bacitracin zinc 500 [USP'U]/g	OintmentTopical	United Exchange Corp.	65923-491
Ecolab Triple Antibioticbacitracin, neomycin sulfate, polymyxin b sulfate	Neomycin sulfate 3.5 mg/g + 2 more ingredients	OintmentTopical	Ecolabs Food Safety Specialties, Inc.	71338-121
Bacitracin Zinc	Bacitracin zinc 500 [USP'U]/g	OintmentTopical	EQUATE (Wal-Mart Stores, Inc.) (see also WAL-MART INC)	49035-510
Thera Plus Original Strength Triple Antibioticbacitracin zinc, neomycin sulfate, polymyxin b sulfate	Bacitracin zinc 400 U/g + 2 more ingredients	OintmentTopical	Fourstar Group USA, Inc	80684-198
Antibiotic and Pain Reliefneomycin, polymyxin b, pramoxine hydrochloride	Neomycin sulfate 3.5 mg/g + 2 more ingredients	CreamTopical	CVS Pharmacy	69842-754
Lightning X Triple Antibioticbacitracin zinc, neomycin sulfate, polymyxin b sulfate	Polymyxin b sulfate 5000 [USP'U]/g + 2 more ingredients	OintmentTopical	Nantong Health & Beyond Hygienic Products Inc.	43473-301
Premier Value Bacitracin Zincbacitracin zinc	Bacitracin zinc 500 [USP'U]/g	OintmentTopical	Pharmacy Value Alliance LLC	68016-107

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