What is NDC 81777-104?

81777-104 is the product NDC for Xesso Rear Comfort Glide (lidocaine), Lidocaine hydrochloride 2.35 g/100mL gel, listed with the FDA by PREMIUM NATURAL COSMETICS INC. It has 1 package NDC, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Xesso Rear Comfort Glide (Lidocaine).

PREMIUM NATURAL COSMETICS INC, NDC labeler code 81777. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.

What other NDCs exist for Xesso Rear Comfort Glide?

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.

Xesso Rear Comfort Glide NDC 81777-104

NDC codes

FDA NDC Directory

Product NDC (as listed)81777-104Labeler and product segments. Claims need a package NDC.

Product NDC at billing width81777-0104Add 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
81777-104-01	81777010401	245 mL in 1 BOTTLE, PLASTIC (81777-104-01)Marketed from Nov 10, 2022

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): Xesso Rear Comfort Glide
Generic name (nonproprietary): lidocaine
Active ingredients: Lidocaine hydrochloride — 2.35 g/100mL
Dosage form: Gel
Route: Rectal
Labeler: PREMIUM NATURAL COSMETICS INCNDC labeler code 81777
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 015
Marketing start: Nov 10, 2022
Listing expires: Dec 31, 2026
Other FDA classes: Amides (Chemical structure)Local Anesthesia (Physiologic effect)
Identifiers: Product ID 81777-104_41ca9e66-02d5-f784-e063-6394a90a2645SPL ID 41ca9e66-02d5-f784-e063-6394a90a2645SPL set ID e9eb262e-a1c1-7d5c-e053-2a95a90a7c9fUNII V13007Z41AUPC 0850030994363
Pharmacologic class: Amide Local Anesthetic; Antiarrhythmic

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

N481777010401 followed by a unit qualifier and the quantity

Package 81777-0104-01. 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)

Use For temporary relief of pain, soreness, or burning in the perianal area.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 81777-104

What is NDC 81777-104?: 81777-104 is the product NDC for Xesso Rear Comfort Glide (lidocaine), Lidocaine hydrochloride 2.35 g/100mL gel, listed with the FDA by PREMIUM NATURAL COSMETICS INC. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Xesso Rear Comfort Glide (Lidocaine).
What is the active ingredient?: Lidocaine hydrochloride.
Who is the labeler?: PREMIUM NATURAL COSMETICS INC, NDC labeler code 81777. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Xesso Rear Comfort Glide?: 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 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
0.25 % PHENYLEPHRINE HCl HEMORRHOIDALmineral oil, petrolatum, phenylephrine hydrochloride	Mineral oil 14 g/100g + 2 more ingredients	OintmentTopical	Nantong Health & Beyond Hygienic Products Inc.	43473-094
0.25 % PHENYLEPHRINE HCl HEMORRHOIDALmineral oil, petrolatum, phenylephrine hydrochloride	Mineral oil 14 g/100g + 2 more ingredients	OintmentTopical	Universal Distribution Center LLC	52000-438
5% Lidocaine 10g5% lidocaine	Lidocaine 5 g/100g	CreamTopical	Chongqing Mandongzi Technology Co., Ltd	88002-001
Acolye Numbing Cream Anorectal(Hemorrhoidal) Creamlidocaine	Lidocaine 5 g/100g	CreamTopical	Guangzhou Haishi Biological Technology Co., Ltd.	60771-0028
Acolye Numbing Cream Anorectal(Hemorrhoidal) Creamlidocaine	Lidocaine 5 g/100g	CreamTopical	Guangzhou Haishi Biological Technology Co., Ltd.	60771-0029
Acolye Numbing Cream Anorectal(Hemorrhoidal) Creamlidocaine	Lidocaine 5 g/100g	CreamTopical	Guangdong Aimu Biological Technology Co., Ltd	83566-615
Adellina Lidocaine Numbing Cream Anorectal(Hemorrhoidal) Creamlidocaine	Lidocaine 5 g/100g	CreamTopical	Guangzhou Haishi Biological Technology Co., Ltd.	60771-0041
Adellina Lidocaine Numbing Cream Topical Anorectal Creamlidocaine	Lidocaine 5 g/100g	CreamTopical	Guangdong Aimu Biological Technology Co., Ltd	83566-612
Adellina Lidocaine Numbing Cream Topical Anorectal Creamlidocaine	Lidocaine 5 g/100g	CreamTopical	Guangdong Aimu Biological Technology Co., Ltd	83566-614
ADVANCED NUMB Topical Anestheticlidocaine hydrochloride	Lidocaine hydrochloride 50 mg/g	CreamTopical	Uber Scientific, LLC	71131-052
AER Pre-moistened Witch Hazel Padwitch hazel	Witch hazel 500 mg/mL	SolutionRectal, Topical	Birchwood Laboratories LLC	50289-3250
AER Traveler Toweletteaer traveler	Witch hazel .5 g/1	SolutionRectal, Topical	Birchwood Laboratories LLC	50289-4200
Americainebenzocaine	Benzocaine 5.6 g/28g	OintmentTopical	Insight Pharmaceuticals LLC	63736-375
AnievaLClidocaine	Lidocaine .05 g/g	CreamTopical	Blackstone Products, LLC	87798-001
ANIXIKE Numbinglidocaine4% numbing	Lidocaine 4 g/100g	CreamTopical	Jiangxi Yudexi Pharmaceutical Co., LTD	85248-166
Arlun LIDOCAINE Creamlidocaine cream	Lidocaine 5 g/100g	CreamTopical	Guangzhou Jingliang Cosmetics Co., Ltd.	87408-021
Assured Bikini Smooth Creamlidocaine	Lidocaine 2 g/100g	CreamTopical	Zhejiang Jingwei Pharmaceutical Co., Ltd.	55621-011
Asteroidmenthol, petrolatum, zinc oxide	Menthol .098 g/28g + 2 more ingredients	OintmentTopical	HEALTHTEX LIMITED	84107-552
B-SURE Traveler Toweletteb-sure traveler	Witch hazel .5 g/g	SolutionRectal, Topical	Birchwood Laboratories LLC	50289-9250
Barrier Protectant Creambarrier cream	Menthol 1 mg/g; Zinc oxide 200 mg/g	OintmentTopical	Cardinal Health	63517-003

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Xesso Rear Comfort Glide (Lidocaine) NDC 81777-104