NDC codes

FDA NDC Directory
Product NDC (as listed)0113-0087Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00113-0087Add 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
0113-0087-530011300875312 BLISTER PACK in 1 CARTON (0113-0087-53) / 1 TABLET in 1 BLISTER PACKMarketed from Oct 11, 2018
0113-0087-620011300876224 BLISTER PACK in 1 CARTON (0113-0087-62) / 1 TABLET in 1 BLISTER PACKMarketed from Jun 10, 2019

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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)
good sense anti diarrheal anti gas
Generic name (nonproprietary)
loperamide hydrochloride, simethicone
Active ingredients
Loperamide hydrochloride — 2 mg/1Dimethicone — 125 mg/1
Dosage form
Tablet
Route
Oral
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 209837
Marketing start
Listing expires
Other FDA classes
Opioid Agonists (Mechanism)Skin Barrier Activity (Physiologic effect)
Identifiers
Product ID 0113-0087_7fbd19ec-7b82-4f11-95f0-28801a9c64b4SPL ID 7fbd19ec-7b82-4f11-95f0-28801a9c64b4SPL set ID 2cda08a8-3f5e-430c-84a3-d29b97d647afRxCUI 978001UNII 77TI35393C, 92RU3N3Y1O
Pharmacologic class
Opioid Agonist

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

N400113008753 followed by a unit qualifier and the quantity

Package 00113-0087-53. 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 209837

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

FDA NDC Directory listings under ANDA 209837
ProductStrengthForm · routeLabelerProduct NDC
dg health anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralDolgencorp, LLC55910-383
Basic Care Loperamide Hydrochloride and Simethiconeloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralAmazon.com Services LLC72288-001
anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralHyVee Inc42507-699
CareOne Diarrhea and Gas Controlloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralAmerican Sales Company41520-772
foster and thrive anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralStrategic Sourcing Services LLC70677-1105
Good Sense Anti Diarrheal Anti Gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralL. Perrigo Company0113-1087
anti diarrheal plus anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralMeijer Distribution Inc41250-375
equaline anti diarrheal plus anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralUnited Natural Foods, Inc. dba UNFI41163-553
signature care anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralSafeway21130-183
anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralRite Aid Corporation11822-1003
anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralH E B37808-714
good neighbor pharmacy anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralAmerisource Bergen46122-620
anti diarrheal and anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralCVS Pharmacy69842-644
anti diarrheal and anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralWalgreen Company0363-1830
Anti Diarrheal Anti Gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralKroger Company30142-581
up and up anti diarrheal anti gasloperamide hydrochloride, simethiconeLoperamide hydrochloride 2 mg/1; Dimethicone 125 mg/1TabletOralTarget Corporation11673-646

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