NDC codes

FDA NDC Directory
Product NDC (as listed)0363-0124Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00363-0124Add 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
0363-0124-05003630124053 CONTAINER in 1 CARTON (0363-0124-05) / 24 LOZENGE in 1 CONTAINER (0363-0124-03)Marketed from Sep 15, 2009
0363-0124-10003630124104 CONTAINER in 1 CARTON (0363-0124-10) / 27 LOZENGE in 1 CONTAINER (0363-0124-09)Marketed from Sep 16, 2009

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)
nicotine
Generic name (nonproprietary)
nicotine polacrilex
Active ingredients
Nicotine — 2 mg/1
Dosage form
Lozenge
Route
Oral
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 090711
Marketing start
Listing expires
Other FDA classes
Nicotine (Chemical structure)
Identifiers
Product ID 0363-0124_0ba190cf-8759-426e-aad1-9a9429c80842SPL ID 0ba190cf-8759-426e-aad1-9a9429c80842SPL set ID 4a81d378-009d-43a9-a895-e371ffa700e9RxCUI 359817UNII 6M3C89ZY6RUPC 0012345678905
Pharmacologic class
Cholinergic Nicotinic 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

N400363012405 followed by a unit qualifier and the quantity

Package 00363-0124-05. 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)

Use • reduces withdrawal symptoms, including nicotine craving, associated with quitting smoking

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 090711

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

FDA NDC Directory listings under ANDA 090711
ProductStrengthForm · routeLabelerProduct NDC
nicotineNicotine 4 mg/1LozengeOralH E B37808-383
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralWalgreen Company0363-4190
nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralMeijer Distribution Inc41250-700
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralCVS WOONSOCKET PRESCRIPTION CENTER, INCORPORATED51316-190
nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralRite Aid Corporation11822-0124
Topcare Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralTopco Associates LLC36800-539
Kirkland Signature NicotinenicotineNicotine 4 mg/1LozengeOralCostco Wholesale Company63981-190
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralKroger Company30142-124
nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralMeijer Distribution Inc41250-190
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralCVS Pharmacy59779-397
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralAmazon.com Services LLC72288-771
basic care nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralAmazon.com Services LLC72288-124
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralKroger Company30142-190
Basic Care Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralAmazon.com Services LLC72288-190
nicotineNicotine 2 mg/1LozengeOralH E B37808-533
equate nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralWal-Mart Stores Inc49035-124
Equate Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralWal-Mart Stores Inc49035-190
Kirkland Signature NicotinenicotineNicotine 2 mg/1LozengeOralCostco Wholesale Company63981-124
Good Sense Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralL. Perrigo Company0113-1125
nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralPublix Super Markets Inc56062-499

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