hemorrhoidal relief NDC 11822-0005

NDC codes

FDA NDC Directory

Product NDC (as listed)11822-0005Labeler and product segments. Claims need a package NDC.

Product NDC at billing width11822-0005Add 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
11822-0005-1	11822000501	12 BLISTER PACK in 1 CARTON (11822-0005-1) / 1 SUPPOSITORY in 1 BLISTER PACKMarketed from Jan 9, 2015
11822-0005-2	11822000502	24 BLISTER PACK in 1 CARTON (11822-0005-2) / 1 SUPPOSITORY in 1 BLISTER PACKMarketed from Jan 9, 2015

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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): hemorrhoidal relief
Generic name (nonproprietary): cocoa butter, phenylephrine hcl
Active ingredients: Cocoa butter — 2211 mg/1Phenylephrine hydrochloride — 6.5 mg/1
Dosage form: Suppository
Route: Rectal
Labeler: Rite Aid Corporation
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 015
Marketing start: Jan 9, 2015
Listing expires: Dec 31, 2026
Other FDA classes: Adrenergic alpha1-Agonists (Mechanism)
Identifiers: Product ID 11822-0005_18859db7-058e-4317-bc83-e32abf20c2b5SPL ID 18859db7-058e-4317-bc83-e32abf20c2b5SPL set ID ddafbdca-32c2-49c1-83d3-35b4155958c9RxCUI 1438497UNII 512OYT1CRR, 04JA59TNSJ
Pharmacologic class: alpha-1 Adrenergic Agonist

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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

NDC on a medical claim

N411822000501 followed by a unit qualifier and the quantity

Package 11822-0005-01. 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 Aug 15, 2024.

Indications (excerpt from the label)

Uses • helps relieve the local itching and discomfort associated with hemorrhoids • temporarily relieves burning and shrinks hemorrhoidal tissue • temporarily provides a coating for relief of anorectal discomforts • temporarily protects the inflamed, irritated anorectal surface to help make bowel movements less painful

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under M 015

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

FDA NDC Directory listings under M 015
Product	Strength	Form · route	Labeler	Product NDC
Chamosynbarrier cream	Menthol 1 mg/g; Zinc oxide 200 mg/g	OintmentTopical	Links Medical Products	51028-002
Hemorrhoid Relief Creamlidocaine 5% anorectal	Lidocaine 50 mg/g	CreamTopical	ALAINA HEALTHCARE PRIVATE LIMITED	73492-712
Hemorrhoidalcocoa butter, phenylephrine hcl	Cocoa butter 2.39 g/1; Phenylephrine hydrochloride 6.75 mg/1	SuppositoryRectal	Amerisourcebergen Drug Corporation	46122-777
Family wellnessmineral oil, petrolatum, phenylephrine hcl	Mineral oil 14 g/100g + 2 more ingredients	OintmentTopical	FRONT PHARMACEUTICAL PLC	69571-006
Kroger Medicated Wipes Hemorrhoidal Wipe With Witch Hazel And Aloewitch hazel cloth	Witch hazel .5 g/g	SwabTopical	The Kroger Co.	30142-791
TN Dickinsons Witch Hazel Hemorrhoidal Padswitch hazel	Witch hazel 1.2 g/1	ClothTopical	Dickinson Brands Inc.	52651-003
T.N. Dickinsons Witch Hazel Medicated Cooling Pads Hemorrhoidal Reliefwitch hazel	Witch hazel .034 g/1	ClothTopical	Dickinson Brands Inc.	52651-010
Norms Hemorrhoidphenylephrine hydrochloride, witch hazel	Witch hazel 50 g/100g; Phenylephrine hydrochloride .25 g/100g	SprayTopical	Totally Normal Company	85996-135
hemorrhoidalcocoa butter, phenylephrine hcl	Cocoa butter 2211 mg/1; Phenylephrine hydrochloride 6.5 mg/1	SuppositoryRectal	H E B	37808-279
Dermatool Hemorrhoidalglycerin, lidocaine, petrolatum, phenylephrine hcl	Lidocaine 5 g/100g + 3 more ingredients	CreamTopical	Papalo Group LLC	84728-413
Norms Medicated Wipeswitch hazel	Witch hazel .5 g/g	ClothTopical	Totally Normal Company	85996-001
Walgreens Hemorrhoidal Pain Reliefglycerin 14.4%, lidocaine 5%, petrolatum 15%, phenylephrine hcl 0.25%	Lidocaine 5 g/100g + 3 more ingredients	CreamTopical	Walgreens	0363-1217
Norms Hemorrhoid Wipeswitch hazel	Witch hazel .5 g/g	ClothTopical	Totally Normal Company	85996-002
Norms Hemorrhoidglycerin, lidocaine, petrolatum, phenylephrine hcl	Lidocaine 5 g/100g + 3 more ingredients	CreamTopical	Totally Normal Company	85996-173
ReVIVOL-XRphenylephrine hydrochloride	Phenylephrine hydrochloride 6.25 mg/1	SuppositoryRectal	Unipack LLC	43749-432
Preparation Hcocoa butter, phenylephrine hydrochloride	Cocoa butter 2211 mg/1; Phenylephrine hydrochloride 6.25 mg/1	SuppositoryRectal	Haleon US Holdings LLC	0573-2883
FAMILY Wellness MEDICATED HEMORRHOIDAL WIPESwitch hazel	Witch hazel 50 g/100mL	ClothTopical	Family Dollar Stores, Inc	55319-774
Walgreens Hemorrhoidalhemorrhoidal rectal suppositories	Cocoa butter 2211 mg/1; Phenylephrine hydrochloride 6.25 mg/1	SuppositoryRectal	Walgreens	0363-0476
Recticarelidocaine and glycerin	Lidocaine 50 mg/g; Glycerin 200 mg/g	ClothTopical	Ferndale Laboratories, Inc.	0496-0980
Kroger Hemorrhoidglycerin, lidocaine, petrolatum, phenylephrine hcl	Lidocaine 5 g/100g + 3 more ingredients	CreamTopical	Kroger Company	30142-713

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