NDC codes

FDA NDC Directory
Product NDC (as listed)17714-040Labeler and product segments. Claims need a package NDC.
Product NDC at billing width17714-0040Add 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
17714-040-601771400406060 TABLET, CHEWABLE in 1 BOTTLE (17714-040-60)Marketed from Nov 1, 2012

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)
Simethicone
Generic name (nonproprietary)
simethicone
Active ingredients
Dimethicone — 125 mg/1
Dosage form
Tablet, Chewable
Route
Oral
Product type
Over-the-counter drug
Marketing category
OTC monograph (final)Application part332
Marketing start
Listing expires
Other FDA classes
Skin Barrier Activity (Physiologic effect)
Identifiers
Product ID 17714-040_7d3cccab-252a-cd80-e053-2a91aa0acbccSPL ID 7d3cccab-252a-cd80-e053-2a91aa0acbccSPL set ID e11928e8-b9db-43c5-972b-33b325090dfcRxCUI 314221UNII 92RU3N3Y1OUPC 0017714040604

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

N417714004060 followed by a unit qualifier and the quantity

Package 17714-0040-60. 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)

Uses relieves bloating pressure discomfort of gas which can be caused by certain foods or air swallowing

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under part332

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

FDA NDC Directory listings under part332
ProductStrengthForm · routeLabelerProduct NDC
Antacidaluminum hydroxide, magnesium hydroxide and simethiconeAluminum hydroxide 400 mg/5mL + 2 more ingredientsSuspensionOralSafeway21130-508
SimethiconeDimethicone 80 mg/1Tablet, ChewableOralRichmond Pharmaceuticals, Inc.54738-518
Antacidaluminum hydroxide, magnesium hydroxide and simethiconeAluminum hydroxide 400 mg/5mL + 2 more ingredientsSuspensionOralCVS69842-508
Infants Non-staining Gas reliefsimethiconeDimethicone 20 mg/.3mLSolution/ dropsOralH E B37808-014
Gas ReliefsimethiconeDimethicone 80 mg/1Tablet, ChewableOralAdvance Pharmaceutical Inc.17714-019
Family Wellness Extra Strength Gas Relief CherrysimethiconeDimethicone 125 mg/1Tablet, ChewableOralFamily Dollar Services, Inc.55319-134
Gas ReliefsimethiconeDimethicone 125 mg/1Tablet, ChewableOralSafeway21130-135

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