What is NDC 30142-504?

30142-504 is the product NDC for Gentlelax (polyethylene glycol 3350), Polyethylene glycol 3350 17 g/17g powder, for solution, listed with the FDA by Kroger Company. It has 1 package NDC, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Gentlelax (Polyethylene Glycol 3350).

Kroger Company, NDC labeler code 30142. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.

What other NDCs exist for Gentlelax?

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.

Gentlelax NDC 30142-504 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)30142-504Labeler and product segments. Claims need a package NDC.

Product NDC at billing width30142-0504Add 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
30142-504-02	3014205040230142050402	238 g in 1 CONTAINER (30142-504-02)Marketed from Jun 20, 2024

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): Gentlelax
Generic name (nonproprietary): polyethylene glycol 3350
Active ingredients: Polyethylene glycol 3350 — 17 g/17g
Dosage form: Powder, For solution
Route: Oral
Labeler: Kroger CompanyNDC labeler code 30142
Product type: Over-the-counter drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 090685
Marketing start: Jun 20, 2024
Listing expires: Dec 31, 2026
Other FDA classes: Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers: Product ID 30142-504_e1f2a9bc-4f0c-4bf3-847f-e8a806c6856fSPL ID e1f2a9bc-4f0c-4bf3-847f-e8a806c6856fSPL set ID 2390b507-93d5-43a0-aa51-31ca4edd6b7fRxCUI 876193, 1049423UNII G2M7P15E5PUPC 0041260021947
Pharmacologic class: Osmotic Laxative

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

N430142050402 followed by a unit qualifier and the quantity

Package 30142-0504-02. 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 Jul 3, 2024.

Indications (excerpt from the label)

Use • relieves occasional constipation (irregularity) • generally produces a bowel movement in 1 to 3 days

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 30142-504

What is NDC 30142-504?: 30142-504 is the product NDC for Gentlelax (polyethylene glycol 3350), Polyethylene glycol 3350 17 g/17g powder, for solution, listed with the FDA by Kroger Company. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Gentlelax (Polyethylene Glycol 3350).
What is the active ingredient?: Polyethylene glycol 3350.
Who is the labeler?: Kroger Company, NDC labeler code 30142. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Gentlelax?: 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 ANDA 090685

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

FDA NDC Directory listings under ANDA 090685
Product	Strength	Form · route	Labeler	Product NDC
dg health clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Dolgencorp, LLC	55910-306
good neighbor pharmacy clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amerisource Bergen	46122-805
equaline clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	United Natural Foods, Inc. dba UNFI	41163-306
Members Mark clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Sam's West Inc	68196-306
berkley and jensen clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	BJWC	68391-306
clear laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Meijer Distribution Inc	41250-306
MiraLAX Orange Flavorpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Bayer HealthCare LLC.	11523-0122
Good Neighbor Pharmacy ClearLaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amerisource Bergen	46122-014
Exchange Select ClearLaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Army & Air Force Exchange Service	55301-306
Good Sense Clear Laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Preferred Pharmaceuticals Inc.	68788-8795
kirkland signature laxaclear original prescription strengthpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Costco Wholesale Company	63981-306
purelaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	CVS Pharmacy	59779-306
gentle laxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Kroger Company	30142-306
Topcare ClearLaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Topco Associates LLC	76162-119
rugby PEG 3350polyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Bryant Ranch Prepack	72162-2155
signature care clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Safeway	21130-847
purelaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	CVS Pharmacy	69842-458
Polyethylene Glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Bryant Ranch Prepack	72162-2172
Clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amazon.com Services LLC	72288-471
basic care clearlaxpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	Amazon.com Services LLC	72288-499

Showing 20 of 39.

Gentlelax (Polyethylene glycol 3350) NDC 30142-504