Over-the-counter drug · OTC MONOGRAPH DRUG
CVS Health Lice Killing (Piperonyl butoxide, pyrethrum extract) NDC 69842-250
Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL · Shampoo · Topical · CVS
NDC codes
FDA NDC DirectoryProduct NDC (as listed)69842-250Labeler and product segments. Claims need a package NDC.
Product NDC at billing width69842-0250Add the package segment from the table below.
| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 69842-250-04 | 6984202500469842025004 | 1 BOTTLE in 1 CARTON (69842-250-04) / 177 mL in 1 BOTTLEMarketed from Jan 3, 2014 | |
| 69842-250-08 | 6984202500869842025008 | 1 BOTTLE in 1 CARTON (69842-250-08) / 236 mL in 1 BOTTLEMarketed from Oct 28, 2010 |
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)
- CVS Health Lice Killing
- Generic name (nonproprietary)
- piperonyl butoxide, pyrethrum extract
- Active ingredients
- Piperonyl butoxide — 4 g/100mLPyrethrum extract — .33 g/100mL
- Dosage form
- Shampoo
- Route
- Topical
- Labeler
- CVSNDC labeler code 69842
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication M 031
- Marketing start
- Listing expires
- Identifiers
- Product ID 69842-250_29a1675d-49fd-d186-e063-6294a90af63dSPL ID 29a1675d-49fd-d186-e063-6294a90af63dSPL set ID 49da5655-28ab-09cf-e054-00144ff8d46cRxCUI 283219UNII LWK91TU9AH, ZUM06L90GVUPC 0050428384664
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
N469842025004followed by a unit qualifier and the quantityPackage 69842-0250-04. 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)
Uses treats head, pubic (crab), and body lice
Excerpt only. Read the full label for complete information.
About NDC 69842-250
- What is NDC 69842-250?
- 69842-250 is the product NDC for CVS Health Lice Killing, Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL shampoo, listed with the FDA by CVS. It has 2 package NDCs, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- CVS Health Lice Killing (Piperonyl butoxide, Pyrethrum extract).
- What is the active ingredient?
- Piperonyl butoxide, Pyrethrum extract.
- Who is the labeler?
- CVS, NDC labeler code 69842. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for CVS Health Lice Killing?
- 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 M 031
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
| Product | Strength | Form · route | Labeler | Product NDC |
|---|---|---|---|---|
| CVS 3 Step Lice Solutionpiperonyl butoxide, pyrethrum extract | — | KitTopical | CVS | 69842-255 |
| CVS 3 Step Lice Solutionpiperonyl butoxide, pyrethrum extract | — | KitTopical | CVS | 69842-255 |
| Major Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | Major Pharmaceuticals | 0904-7349 |
| Kroger Complete Lice Treatment Kitpiperonyl butoxide, pyrethrum extract | — | KitTopical | The Kroger Co | 30142-252 |
| Rite Aid Complete Lice Elimination Kitpiperonyl butoxide, pyrethrum extract | — | KitTopical | Rite Aid | 11822-6611 |
| Kroger Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | The Kroger Co | 30142-253 |
| Rite Aid Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | Rite Aid Corp | 11822-6616 |
| Lice Killingpiperonyl butoxide, pyrethrum extract | Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL | ShampooTopical | Weeks & Leo Co., Inc. | 11383-310 |
| Lice Killingpiperonyl butoxide, pyrethrum extract | Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL | ShampooTopical | PHARMACY VALUE ALLIANCE LLC | 68016-253 |
| Mata Piojos Licepiperonyl butoxide, pyrethrum extract | Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL | ShampooTopical | GRANDALL DISTRIBUTING, LLC | 48201-006 |
| ABC Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | Weeks & Leo Co., Inc. | 11383-312 |
| El Piojito Lice Killingpiperonyl butoxide, pyrethrum extract | Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL | ShampooTopical | Pharmadel | 55758-253 |
| Topcare Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | Topco Associates, LLC | 76162-253 |
| Topcare Complete Lice Treatment Kitpiperonyl butoxide, pyrethrum extract | — | KitTopical | Topco Associates, LLC | 76162-255 |
| Premier Value Lice Treatment Kitpiperonyl butoxide, pyrethrum extract | — | KitTopical | PHARMACY VALUE ALLIANCE LLC | 68016-552 |
| Walgreens Lice Killingpiperonyl butoxide, pyrethrum extract | Piperonyl butoxide 4 g/100mL; Pyrethrum extract .33 g/100mL | ShampooTopical | Walgreens CO | 0363-1253 |
| Leader Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | LEADER/ Cardinal Health 110, Inc. | 70000-0633 |
| Walgreens Lice Eliminationpiperonyl butoxide, pyrethrum extract | — | KitTopical | Walgreens | 0363-3255 |
| Meijer Complete Lice Treatment Kitpiperonyl butoxide, pyrethrum extract | — | KitTopical | Meijer, Inc. | 79481-2550 |
| Meijer Lice Killingpiperonyl butoxide, pyrethrum extract | Pyrethrum extract .33 g/100mL; Piperonyl butoxide 4 g/100mL | ShampooTopical | Meijer, Inc. | 79481-2530 |
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