NDC codes

FDA NDC Directory
Product NDC (as listed)58602-805Labeler and product segments. Claims need a package NDC.
Product NDC at billing width58602-0805Add 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
58602-805-0158602080501119 g in 1 BOTTLE, PLASTIC (58602-805-01)Marketed from Apr 9, 2018
58602-805-0258602080502238 g in 1 BOTTLE, PLASTIC (58602-805-02)Marketed from Apr 9, 2018
58602-805-0358602080503510 g in 1 BOTTLE, PLASTIC (58602-805-03)Marketed from Apr 9, 2018
58602-805-0458602080504850 g in 1 BOTTLE, PLASTIC (58602-805-04)Marketed from Apr 9, 2018
58602-805-2558602080525765 g in 1 BOTTLE, PLASTIC (58602-805-25)Marketed from Apr 23, 2024
58602-805-275860208052714 PACKET in 1 CARTON (58602-805-27) / 17 g in 1 PACKETMarketed from Apr 23, 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)
Polyethylene Glycol 3350
Generic name (nonproprietary)
polyethylene glycol 3350
Active ingredients
Polyethylene glycol 3350 — 17 g/17g
Dosage form
Powder, For solution
Route
Oral
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 209017
Marketing start
Listing expires
Other FDA classes
Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers
Product ID 58602-805_af3011d1-9e74-42f2-bbc8-8f08c45898eaSPL ID af3011d1-9e74-42f2-bbc8-8f08c45898eaSPL set ID d3c77f3f-57aa-4e2d-88aa-731cbb22af70RxCUI 876193UNII G2M7P15E5PUPC 0358602805012
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

N458602080501 followed by a unit qualifier and the quantity

Package 58602-0805-01. 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 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)

Other NDCs under ANDA 209017

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

FDA NDC Directory listings under ANDA 209017
ProductStrengthForm · routeLabelerProduct NDC
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralAurobindo Pharma Limited84386-125
Comfortlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralFamily Dollar Stores, LLC55319-056
365 WHOLE FOODS MARKET Polyethylene Glycol 3350polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralWhole Foods Market, Inc.42681-0059
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCARDINAL HEALTH 110, LLC. DBA LEADER70000-0699

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