Over-the-counter drug · OTC MONOGRAPH DRUG
RestoraScalp Anti Dandruff Dry Light Roots (Anti dandruff dry shampoo) NDC 84042-101
Salicylic acid 2 g/100g · Powder · Topical · Raven Innovations LLC
NDC codes
FDA NDC DirectoryProduct NDC (as listed)84042-101Labeler and product segments. Claims need a package NDC.
Product NDC at billing width84042-0101Add the package segment from the table below.
| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 84042-101-02 | 8404201010284042010102 | 17.5 g in 1 BOTTLE (84042-101-02)Marketed from Sep 19, 2026 |
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)
- RestoraScalp Anti Dandruff Dry Light Roots
- Generic name (nonproprietary)
- anti dandruff dry shampoo
- Active ingredients
- Salicylic acid — 2 g/100g
- Dosage form
- Powder
- Route
- Topical
- Labeler
- Raven Innovations LLCNDC labeler code 84042
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication M 032
- Marketing start
- Listing expires
- Identifiers
- Product ID 84042-101_5bdc88e2-b0c1-bf88-e063-6394a90af626SPL ID 5bdc88e2-b0c1-bf88-e063-6394a90af626
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
N484042010102followed by a unit qualifier and the quantityPackage 84042-0101-02. 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
The FDA listing for this product does not reference a label (SPL) set.
About NDC 84042-101
- What is NDC 84042-101?
- 84042-101 is the product NDC for RestoraScalp Anti Dandruff Dry Light Roots, Salicylic acid 2 g/100g powder, listed with the FDA by Raven Innovations LLC. It has 1 package NDC, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- RestoraScalp Anti Dandruff Dry Light Roots (Anti Dandruff Dry Shampoo).
- What is the active ingredient?
- Salicylic acid.
- Who is the labeler?
- Raven Innovations LLC, NDC labeler code 84042. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for RestoraScalp Anti Dandruff Dry Light Roots?
- 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 032
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 |
|---|---|---|---|---|
| Walgreens Dandruff and Conditioner Cleansing and Conditioning Anti-dandruffselenium sulfide | Selenium sulfide 10 mg/mL | ShampooTopical | Walgreen Company | 0363-4136 |
| Head and Shoulders Men Daily Pure Sport Old Spicepyrithione zinc | Pyrithione zinc 1 g/100mL | ShampooTopical | The Procter & Gamble Manufacturing Company | 84126-928 |
| Dr Marvel ANTI DANDRUFF SCALP SERUMselenium sulfide salicylic acid | Salicylic acid 2 mg/100mg; Selenium sulfide 2 mg/100mg | SolutionTopical | Guangzhou Liyan Cosmetics Technology Co., Ltd. | 87770-025 |
| Everyday Clean Dandruffpyrithione zinc | Pyrithione zinc 10 mg/mL | ShampooTopical | Topco Associates LLC | 36800-153 |
| Head and Shoulders Clinical Strength Dandruff Defense Advanced Oil Controlselenium sulfide | Selenium sulfide 1 g/100mL | Lotion/shampooTopical | The Procter & Gamble Manufacturing Company | 69423-525 |
| Coal Tar | Coal tar 1.39 g/100mL | OintmentTopical | Nopsor USA Distribution Co., Inc. | 70666-016 |
| Head and Shoulders Clinical Strength Dandruff Defense Intensive Itch Reliefselenium sulfide | Selenium sulfide 1 g/100mL | Lotion/shampooTopical | The Procter & Gamble Manufacturing Company | 69423-526 |
| Coal Tar | Coal tar 5.39 g/250mL | ShampooTopical | Nopsor USA Distribution Co., Inc. | 70666-022 |
| Dr. Groot Anti-dandruff Scalp Caresalicylic acid | Salicylic acid 30 mg/mL | ShampooTopical | LG H&H CO., LTD. | 53208-901 |
| Head and Shoulders 2in1 Clinical Strength Dandruff Defense Intensive Itch Reliefselenium sulfide | Selenium sulfide 1 g/100mL | Lotion/shampooTopical | The Procter & Gamble Manufacturing Company | 69423-527 |
| Rida Hair Research Institute RHRI Neoketramin Antifungal Yeast Relief Treatmentsalicylic acid | Salicylic acid 3 g/100mL | SprayTopical | Rida LLC | 83004-048 |
| X20Hair Anti Fungalfolliculitisshampoozinc pyrithione | Zinc pyrithione 1 mg/100mL | LiquidTopical | Guangzhou Tata Biotechnology Co., Ltd. | 84066-106 |
| Dr. Groot Anti-dandruff Scalp Care 2 in 1salicylic acid | Salicylic acid 30 mg/mL | ShampooTopical | LG H&H CO., LTD. | 53208-902 |
| Dandruffpyrithione zinc | Pyrithione zinc 10 mg/mL | ShampooTopical | Your Military Exchanges | 55301-281 |
| Head and Shoulders 2in1 Men Advanced Series Pure Sport Old Spicepyrithione zinc | Pyrithione zinc 1 g/100mL | Lotion/shampooTopical | The Procter & Gamble Manufacturing Company | 69423-293 |
| Walgreens Everyday Clean Dandruff Anti-Dandruffpyrithione zinc | Pyrithione zinc 10 mg/mL | ShampooTopical | Walgreen Company | 0363-2606 |
| Scalp Revivalsalicylic acid 3% | Salicylic acid 3 g/100mL | ShampooTopical | Beccair, LLC | 82594-001 |
| Dandruffpyrithione zinc | Pyrithione zinc 10 mg/mL | ShampooTopical | United Natural Foods, Inc. dba UNFI | 41163-253 |
| CONTROL Dandruff- Free Beard Washpyrithione zinc | Pyrithione zinc 10 mg/mL | ShampooTopical | Kamedis Inc | 50718-0035 |
| AntiDandruffShampooConditioner365 anti dandruff shampoo conditioner 2 in 1 | Salicylic acid 3 mg/100mL | ShampooTopical | Whole Foods Market, Inc. | 42681-0030 |
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