NDC codes

FDA NDC Directory
Product NDC (as listed)69842-394Labeler and product segments. Claims need a package NDC.
Product NDC at billing width69842-0394Add 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
69842-394-54698420394546984203945415 POUCH in 1 CARTON (69842-394-54) / 2 TABLET, CHEWABLE in 1 POUCHMarketed from Nov 28, 2017

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, Chewable
Route
Oral
Labeler
CVS PHARMACY, INC.NDC labeler code 69842
Product type
Over-the-counter drug
Marketing category
OTC monograph (final)Application part335
Marketing start
Listing expires
Other FDA classes
Bismuth (Chemical structure)
Identifiers
Product ID 69842-394_77bb30e0-35b0-40c8-a07e-98dfa91c1ce9SPL ID 77bb30e0-35b0-40c8-a07e-98dfa91c1ce9SPL set ID 65dbe287-4528-4dbd-9116-6d4812fd4fa2RxCUI 308761UNII 62TEY51RR1
Pharmacologic class
Bismuth

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

N469842039454 followed by a unit qualifier and the quantity

Package 69842-0394-54. 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 travelers' diarrhea diarrhea upset stomach due to overindulgence in food and drink, including: heartburn indigestion nausea gas belching fullness

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 69842-394

What is NDC 69842-394?
69842-394 is the product NDC for Stomach Relief (bismuth subsalicylate), Bismuth subsalicylate 262 mg/1 tablet, chewable, listed with the FDA by CVS PHARMACY, INC.. It has 1 package NDC, 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 PHARMACY, INC., 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/1TabletOralCVS69842-172

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