What is the NDC for GoLYTELY?

GoLYTELY has 2 product NDCs, one for each strength, dosage form and labeler; each product NDC then has one package NDC per package size. Pick the row for your product above to see its package NDCs.

Is there a J-code for GoLYTELY?

Med-Code's curated HCPCS directory has no drug-specific code for these products. Drugs dispensed by a pharmacy are billed by NDC.

Which NDC goes on a claim?

The package NDC of what was given, in 11-digit form.

GoLYTELY NDC Codes & NDC Number

Overview

Active ingredients: Polyethylene glycol 3350, Sodium sulfate anhydrous, Sodium bicarbonate, Sodium chloride, Potassium chloride. Each product below links to its own NDC page with package NDCs in 10- and 11-digit form.

Generic name: Polyethylene Glycol 3350, Sodium Sulfate Anhydrous, Sodium Bicarbonate, Sodium Chloride, Potassium Chloride
Active ingredients: Polyethylene glycol 3350, Sodium sulfate anhydrous, Sodium bicarbonate, Sodium chloride, Potassium chloride
Labelers: Azurity Pharmaceuticals, Inc., Braintree Laboratories, Inc.
Strengths: Polyethylene glycol 3350 236 g/4L; Sodium sulfate anhydrous 22.74 g/4L; Sodium bicarbonate 6.74 g/4L; Sodium chloride 5.86 g/4L; Potassium chloride 2.97 g/4L
Dosage forms: Powder, For solution
Routes: Oral
Drug classes (FDA established): Osmotic Laxative, Potassium Salt
HCPCS / J-code: None in Med-Code's directory for these products
Package NDCs: 2

NDC codes

Newest listings first. Each row links to the product’s NDC page.

GoLYTELY NDC Codes: finished products
Product	Strength	Form · route	Labeler	Product NDC	Package NDCs (11-digit)	HCPCS
GoLYTELYpolyethylene glycol 3350, sodium sulfate anhydrous, sodium bicarbonate, sodium chloride, potassium chloride	Polyethylene glycol 3350 236 g/4L + 4 more ingredients	Powder, For solutionOral	Azurity Pharmaceuticals, Inc.	24338-236	24338-0236-01	—
GoLYTELYpolyethylene glycol 3350, sodium sulfate anhydrous, sodium bicarbonate, sodium chloride, potassium chloride	Polyethylene glycol 3350 236 g/4L + 4 more ingredients	Powder, For solutionOral	Braintree Laboratories, Inc.	52268-100	52268-0100-01	—

GoLYTELY: common questions

What is the NDC for GoLYTELY?: GoLYTELY has 2 product NDCs, one for each strength, dosage form and labeler; each product NDC then has one package NDC per package size. Pick the row for your product above to see its package NDCs.
Is there a J-code for GoLYTELY?: Med-Code's curated HCPCS directory has no drug-specific code for these products. Drugs dispensed by a pharmacy are billed by NDC. NDC vs J-code.
Which NDC goes on a claim?: The package NDC of what was given, in 11-digit form. How to convert a 10-digit NDC.