NDC codes

FDA NDC Directory
Product NDC (as listed)0169-4505Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00169-4505Add 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
0169-4505-14001694505144 SYRINGE, PLASTIC in 1 CARTON (0169-4505-14) / .5 mL in 1 SYRINGE, PLASTIC (0169-4505-01)Marketed from Jun 5, 2021

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)
Wegovy
Generic name (nonproprietary)
semaglutide
Active ingredients
Semaglutide — .5 mg/.5mL
Dosage form
Injection, Solution
Route
Subcutaneous
Labeler
Novo Nordisk Pharmaceutical Industries, LPNDC labeler code 0169
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 215256
Marketing start
Listing expires
Other FDA classes
Glucagon-Like Peptide 1 (Chemical structure)Glucagon-like Peptide-1 (GLP-1) Agonists (Mechanism)
Identifiers
Product ID 0169-4505_f7b108b9-f276-4e32-84e7-e828ba145da5SPL ID f7b108b9-f276-4e32-84e7-e828ba145da5
Pharmacologic class
GLP-1 Receptor 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 codeMed-Code curated

No drug-specific HCPCS code in Med-Code’s directory for this product.

Med-Code's directory has no drug-specific HCPCS code for Wegovy. It is usually self-administered and billed by NDC through a pharmacy benefit. Wegovy tablets are pharmacy-dispensed and have no HCPCS code.

If a payer accepts an unclassified code for it in a clinical setting, that would be J3490 (Unclassified drugs), with the NDC, quantity and often the invoice. Acceptance varies by payer.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N400169450514 followed by a unit qualifier and the quantity

Package 00169-4505-14. 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

The FDA listing for this product does not reference a label (SPL) set.

About NDC 0169-4505

What is NDC 0169-4505?
0169-4505 is the product NDC for Wegovy (semaglutide), Semaglutide .5 mg/.5mL injection, solution, listed with the FDA by Novo Nordisk Pharmaceutical Industries, LP. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Wegovy (Semaglutide).
What is the active ingredient?
Semaglutide.
Who is the labeler?
Novo Nordisk Pharmaceutical Industries, LP, NDC labeler code 0169. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Wegovy?
11 other product NDCs are listed under this name. See all Wegovy 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 Wegovy NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
WegovysemaglutideSemaglutide 9 mg/1TabletOralNovo Nordisk Pharmaceutical Industries, LP0169-440900169-4409-31
WegovysemaglutideSemaglutide 4 mg/1TabletOralNovo Nordisk Pharmaceutical Industries, LP0169-440400169-4404-31
WegovysemaglutideSemaglutide 1.5 mg/1TabletOralNovo Nordisk Pharmaceutical Industries, LP0169-441500169-4415-3100169-4415-92
WegovysemaglutideSemaglutide 25 mg/1TabletOralNovo Nordisk Pharmaceutical Industries, LP0169-442500169-4425-31
WegovysemaglutideSemaglutide 1 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-450100169-4501-14
WegovysemaglutideSemaglutide .25 mg/.5mLInjection, SolutionSubcutaneousA-S Medication Solutions50090-582450090-5824-00
WegovysemaglutideSemaglutide 1.7 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-451700169-4517-14
WegovysemaglutideSemaglutide 2.4 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-452400169-4524-14
WegovysemaglutideSemaglutide .25 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-452500169-4525-1400169-4525-94
WegovysemaglutideSemaglutide 7.2 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-457200169-4572-14

All 12 Wegovy NDCs

Other NDCs under NDA 215256

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

FDA NDC Directory listings under NDA 215256
ProductStrengthForm · routeLabelerProduct NDC
WegovysemaglutideSemaglutide 1 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4501
WegovysemaglutideSemaglutide .25 mg/.5mLInjection, SolutionSubcutaneousA-S Medication Solutions50090-5824
WegovysemaglutideSemaglutide 2.4 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4524
WegovysemaglutideSemaglutide .25 mg/.5mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4525
WegovysemaglutideSemaglutide 7.2 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4572
WegovysemaglutideSemaglutide 3.2 mg/mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4915
WegovysemaglutideSemaglutide 1.7 mg/.75mLInjection, SolutionSubcutaneousNovo Nordisk Pharmaceutical Industries, LP0169-4517

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