nicotine (nicotine polacrilex) NDC 11822-0309

NDC codes

FDA NDC Directory

Product NDC (as listed)11822-0309Labeler and product segments. Claims need a package NDC.

Product NDC at billing width11822-0309Add 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 NDC	11-digit (billing)	Package	Copy
11822-0309-1	11822030901	20 BLISTER PACK in 1 CARTON (11822-0309-1) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from Jan 24, 2017
11822-0309-2	11822030902	100 BLISTER PACK in 1 CARTON (11822-0309-2) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from Jan 24, 2017

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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 — 4 mg/1
Dosage form: Gum, Chewing
Route: Oral
Labeler: Rite Aid Corporation
Product type: Over-the-counter drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 206393
Marketing start: Jan 24, 2017
Marketing end: Sep 30, 2026
Other FDA classes: Nicotine (Chemical structure)
Identifiers: Product ID 11822-0309_f9d4016b-a08e-46d5-8078-a2ff63c4bff6SPL ID f9d4016b-a08e-46d5-8078-a2ff63c4bff6SPL set ID 4dee260e-784b-40a3-aa79-579c36cfc82cRxCUI 311975UNII 6M3C89ZY6R
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

N411822030901 followed by a unit qualifier and the quantity

Package 11822-0309-01. 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

Current FDA label (SPL), effective Mar 27, 2026.

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 206393

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

FDA NDC Directory listings under ANDA 206393
Product	Strength	Form · route	Labeler	Product NDC
Up And Up Coated Fruit Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Target Corporation	82442-971
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Meijer, Inc.	79481-0601
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Meijer Distribution Inc	41250-689
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Walgreen Company	0363-2309
Basic Care Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Amazon.com Services LLC	72288-003
basic care nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Amazon.com Services LLC	72288-693
kirkland signature quit 4nicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Costco Wholesale Company	63981-309
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Kroger Company	30142-848
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Publix Super Markets Inc	56062-019
good sense nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	L. Perrigo Company	0113-8600
Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	CVS WOONSOCKET PRESCRIPTION CENTER, INCORPORATED	51316-309
careone nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	American Sales Company	41520-843
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Walgreen Company	0363-7971
Good Sense Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	L. Perrigo Company	0113-4111
Topcare Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Topco Associates LLC	36800-650
Blipnicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Blip Products, Inc.	82966-309
blipnicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Blip Products, Inc.	82966-971
nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Walgreen Company	0363-7103
Good Sense Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	L. Perrigo Company	0113-0053
Coated Nicotinenicotine polacrilex	Nicotine 4 mg/1	Gum, ChewingOral	Publix Super Markets Inc	56062-369

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