Discount Drug Mart NDC 53943-652

NDC codes

FDA NDC Directory

Product NDC (as listed)53943-652Labeler and product segments. Claims need a package NDC.

Product NDC at billing width53943-0652Add 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
53943-652-14	53943065214	238 g in 1 BOTTLE, PLASTIC (53943-652-14)Marketed from Apr 17, 2023
53943-652-30	53943065230	510 g in 1 BOTTLE, PLASTIC (53943-652-30)Marketed from Apr 17, 2023

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): Discount Drug Mart
Generic name (nonproprietary): polyethylene glycol 3350
Active ingredients: Polyethylene glycol 3350 — 17 g/17g
Dosage form: Powder, For solution
Route: Oral
Labeler: DISCOUNT DRUG MART
Product type: Over-the-counter drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 202071
Marketing start: Apr 17, 2023
Listing expires: Dec 31, 2027
Other FDA classes: Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers: Product ID 53943-652_4d709cd7-ecb0-45e6-9625-bb9a36459a8eSPL ID 4d709cd7-ecb0-45e6-9625-bb9a36459a8e
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

N453943065214 followed by a unit qualifier and the quantity

Package 53943-0652-14. 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

The FDA listing for this product does not reference a label (SPL) set.

Other NDCs under ANDA 202071

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

FDA NDC Directory listings under ANDA 202071
Product	Strength	Form · route	Labeler	Product NDC
Walgreenspolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	WALGREEN COMPANY	0363-5260
Wincopolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	WINCO FOODS	67091-447
Krogerpolyethylene glycol 3350	Polyethylene glycol 3350 17 g/17g	Powder, For solutionOral	KROGER COMPANY	30142-526

Discount Drug Mart (polyethylene glycol 3350) NDC 53943-652