NDC codes

FDA NDC Directory
Product NDC (as listed)72090-036Labeler and product segments. Claims need a package NDC.
Product NDC at billing width72090-0036Add 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
72090-036-017209000360130 PACKET in 1 CARTON (72090-036-01) / 17 g in 1 PACKETMarketed from Mar 5, 2025
72090-036-0272090003602100 PACKET in 1 CARTON (72090-036-02) / 17 g in 1 PACKETMarketed from Mar 5, 2025
72090-036-037209000360310 PACKET in 1 CARTON (72090-036-03) / 17 g in 1 PACKETMarketed from Apr 8, 2026

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 203928
Marketing start
Listing expires
Other FDA classes
Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers
Product ID 72090-036_cb9c7757-d81e-4e31-8390-2102e2f3f182SPL ID cb9c7757-d81e-4e31-8390-2102e2f3f182SPL set ID 478f104a-0e50-479c-8722-a3f1eab68691RxCUI 876193UNII G2M7P15E5PUPC 0372090003460, 0372090003453
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

N472090003601 followed by a unit qualifier and the quantity

Package 72090-0036-01. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

Other NDCs under ANDA 203928

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

FDA NDC Directory listings under ANDA 203928
ProductStrengthForm · routeLabelerProduct NDC
Polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCardinal Health 107, LLC55154-8091
Polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCardinal Health 107, LLC55154-8090
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCardinal Health 107, LLC55154-8184
ez2go Polyethylene Glycol 3350polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionTopicalValley Medical Products, LLC76470-050
Polyethylene Glycol 3350 Powder for Solutionpolyethylene glycol, unspecifiedPolyethylene glycol 3350 17 g/17gPowder, For solutionTopicalVALLEY MEDICAL PRODUCTS, LLC76470-069
Polyethylene Glycol 3350instalax polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralSun Pharmaceutical Industries, Inc.51672-2104
Polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralMajor Pharmaceuticals0904-6931
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralGLENMARK THERAPEUTICS INC., USA72657-196
Mix-In Laxative Packetspolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralWal-Mart Stores Inc49035-906
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralThe Fresh Test, LLC87362-119
Polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCardinal Health 107, LLC55154-2328
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralAmerican Health Packaging60687-431
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralKesin Pharma Corporation81033-762
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralGericare Pharmaceuticals57896-490

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