Over-the-counter drug · OTC MONOGRAPH FINAL

Stomach relief (Bismuth subsalicylate) NDC 69842-172

Bismuth subsalicylate 262 mg/1 · Tablet · Oral · CVS

NDC codes

FDA NDC Directory
Product NDC (as listed)69842-172Labeler and product segments. Claims need a package NDC.
Product NDC at billing width69842-0172Add 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
69842-172-1269842017212698420172121 BOTTLE in 1 CARTON (69842-172-12) / 24 TABLET in 1 BOTTLEMarketed from Mar 4, 2013
69842-172-2869842017228698420172281 BOTTLE in 1 CARTON (69842-172-28) / 40 TABLET in 1 BOTTLEMarketed from Aug 8, 2011

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)
Stomach relief
Generic name (nonproprietary)
bismuth subsalicylate
Active ingredients
Bismuth subsalicylate — 262 mg/1
Dosage form
Tablet
Route
Oral
Labeler
CVSNDC labeler code 69842
Product type
Over-the-counter drug
Marketing category
OTC monograph (final)Application part335
Marketing start
Listing expires
Identifiers
Product ID 69842-172_16c744c8-fe46-4bb4-b272-1a51095acda0SPL ID 16c744c8-fe46-4bb4-b272-1a51095acda0SPL set ID 53cf4590-a625-42f7-bd03-8401d08b6447RxCUI 308760UNII 62TEY51RR1UPC 0050428323847

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

N469842017212 followed by a unit qualifier and the quantity

Package 69842-0172-12. 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: indigestion nausea heartburn diarrhea upset stomach associated with these symptoms

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 69842-172

What is NDC 69842-172?
69842-172 is the product NDC for Stomach relief (bismuth subsalicylate), Bismuth subsalicylate 262 mg/1 tablet, listed with the FDA by CVS. It has 2 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Stomach relief (Bismuth subsalicylate).
What is the active ingredient?
Bismuth subsalicylate.
Who is the labeler?
CVS, NDC labeler code 69842. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Stomach relief?
21 other product NDCs are listed under this name. See all Stomach relief NDCs.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Stomach relief NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1TabletOralKroger41226-47541226-0475-42
Stomach Reliefbismuth subsalicylateBismuth 262 mg/1Capsule, Liquid filledOralShield Pharmaceuticals Corp83059-016683059-0166-08
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLSuspensionOralGrocery Outlet, Inc.85828-79185828-0791-07
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralGrocery Outlet, Inc.85828-72785828-0727-30
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1TabletOralBi-Mart37835-20737835-0207-48
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1TabletOralChain Drug Marketing Association, Inc.83324-06083324-0060-40
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralHarris Teeter, LLC69256-52769256-0527-0469256-0527-05
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralWALMART INC. (see also Equate)79903-31179903-0311-16
Stomach ReliefBismuth subsalicylate 262 mg/1TabletOralChain Drug Marketing Association, Inc.83324-13083324-0130-30
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralWalgreens0363-702400363-7024-1600363-7024-32

All 22 Stomach relief NDCs

Other NDCs under part335

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

FDA NDC Directory listings under part335
ProductStrengthForm · routeLabelerProduct NDC
Equaline Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1TabletOralUNITED NATURAL FOODS, INC. DBA UNFI41163-123
Equaline Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralUNITED NATURAL FOODS, INC. DBA UNFI41163-535
Family wellness Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralFamily Dollar Services, Inc.55319-122
Guardian Pink-Bismuth Cherrybismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralGuardian Drug Company53041-022
Maximum strength Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralCVS69842-528
Pepto Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralAdvance Pharmaceutical Inc.17714-045
Pepto Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralRichmond Pharmaceuticals, Inc54738-102
QCH Stomach Relief 535bismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralChain Drug Marketing Association Inc.83324-022
Quality Choice Regular Strength Stomach Reliefbismuth subsalicylateBismuth subsalicylate 525 mg/30mLLiquidOralChain Drug Marketing Association Inc.83324-020
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralPuraCap Pharmaceutical LLC51013-321
Stomach Reliefbismuth subsalicylateBismuth subsalicylate 262 mg/1Tablet, ChewableOralCVS PHARMACY, INC.69842-394

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