NDC codes

FDA NDC Directory
Product NDC (as listed)50090-5824Labeler and product segments. Claims need a package NDC.
Product NDC at billing width50090-5824Add 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
50090-5824-0500905824004 SYRINGE, PLASTIC in 1 CARTON (50090-5824-0) / .5 mL in 1 SYRINGE, PLASTICMarketed from Oct 25, 2021

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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)
Wegovy
Generic name (nonproprietary)
semaglutide
Active ingredients
Semaglutide.25 mg/.5mL
Dosage form
Injection, Solution
Route
Subcutaneous
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 215256
Marketing start
Listing expires
Other FDA classes
Glucagon-Like Peptide 1 (Chemical structure)Glucagon-like Peptide-1 (GLP-1) Agonists (Mechanism)
Identifiers
Product ID 50090-5824_58b8887c-a572-4a74-ad0b-1049d388e206SPL ID 58b8887c-a572-4a74-ad0b-1049d388e206SPL set ID f5e548d0-cc79-4c34-a3f5-e20a5b8b6564RxCUI 2553501, 2553506UNII 53AXN4NNHX
Pharmacologic class
GLP-1 Receptor 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 codeMed-Code curated

No drug-specific HCPCS code in Med-Code’s directory for this product.

Med-Code's directory has no drug-specific HCPCS code for Wegovy. It is usually self-administered and billed by NDC through a pharmacy benefit. Wegovy tablets are pharmacy-dispensed and have no HCPCS code.

If a payer accepts an unclassified code for it in a clinical setting, that would be J3490 (Unclassified drugs), with the NDC, quantity and often the invoice. Acceptance varies by payer.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N450090582400 followed by a unit qualifier and the quantity

Package 50090-5824-00. 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 . This label includes a boxed warning.

Indications (excerpt from the label)

WEGOVY is indicated in combination with a reduced calorie diet and increased physical activity: • to reduce the risk of major adverse cardiovascular events (cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke) in adults with established cardiovascular disease and either obesity or overweight. • to reduce excess body weight and maintain weight reduction long term in: o Adults and pediatric patients aged 12 years and older with obesity o Adults with overweight in the presence of at least one weight-related comorbid condition. Limitations of Use • WEGOVY contains semaglutide. Coadministration with other semaglutide-containing products or with any other GLP-1 receptor agon

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 215256

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

FDA NDC Directory listings under NDA 215256
ProductStrengthForm · routeLabelerProduct NDC
WegovysemaglutideSemaglutide 1 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4501
WegovysemaglutideSemaglutide .5 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4505
WegovysemaglutideSemaglutide 1.7 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4517
WegovysemaglutideSemaglutide 2.4 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4524
WegovysemaglutideSemaglutide .25 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4525
WegovysemaglutideSemaglutide 7.2 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4572
WegovysemaglutideSemaglutide 3.2 mg/mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4915

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