NDC codes

FDA NDC Directory
Product NDC (as listed)0363-1608Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00363-1608Add 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 NDC11-digit (billing)PackageCopy
0363-1608-6200363160862110 BLISTER PACK in 1 CARTON (0363-1608-62) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from Jan 1, 2014
0363-1608-9800363160898170 BLISTER PACK in 1 CARTON (0363-1608-98) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from Jan 1, 2014

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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)
Nicotine Polacrilex originalSuffix: original
Generic name (nonproprietary)
nicotine polacrilex
Active ingredients
Nicotine2 mg/1
Dosage form
Gum, Chewing
Route
Oral
Labeler
Walgreens
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 074507
Marketing start
Listing expires
Other FDA classes
Nicotine (Chemical structure)
Identifiers
Product ID 0363-1608_ce202975-a51b-43ae-aec6-d64f38f1be16SPL ID ce202975-a51b-43ae-aec6-d64f38f1be16SPL set ID f759d9b2-35e0-4b88-9219-4c0e483af5c4RxCUI 311975, 314119UNII 6M3C89ZY6R
Pharmacologic class
Cholinergic Nicotinic 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 HCPCS code in Med-Code's directory. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N400363160862 followed by a unit qualifier and the quantity

Package 00363-1608-62. 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)

Use reduces withdrawal symptoms, including nicotine craving, associated with quitting smoking

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 074507

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

FDA NDC Directory listings under ANDA 074507
ProductStrengthForm · routeLabelerProduct NDC
Nicotine Polacrilex, Originalnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalChain Drug Consortium, LLC68016-286
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralThe Kroger Co.30142-859
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralMcKesson Corporation dba SKY Packaging63739-371
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralWalgreens0363-9290
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalRugby Laboratories0536-3029
Nicotine Polacrilex Original Flavornicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalPublix Supermarkets, Inc.56062-608
Nicotine Polacrilex originalnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalCVS Pharmacy69842-608
Nicotine Polacrilex Originalnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalCARDINAL HEALTH 110, LLC. DBA LEADER 7000070000-0345
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralP & L Development, LLC59726-929
Nicotinenicotine polacrilexNicotine 2 mg/1Gum, ChewingOralAmerisourceBergen (Good Neighbor Pharmacy) 4612246122-719

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