NDC codes

FDA NDC Directory
Product NDC (as listed)11822-0905Labeler and product segments. Claims need a package NDC.
Product NDC at billing width11822-0905Add 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
11822-0905-4118220905043 BOTTLE, PLASTIC in 1 BOX (11822-0905-4) / 24 LOZENGE in 1 BOTTLE, PLASTICMarketed from Aug 1, 2020
11822-0905-7118220905071 BOTTLE, PLASTIC in 1 BOX (11822-0905-7) / 24 LOZENGE in 1 BOTTLE, PLASTICMarketed from Aug 1, 2020

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
Lozenge
Route
Oral
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 212056
Marketing start
Marketing end
Other FDA classes
Nicotine (Chemical structure)
Identifiers
Product ID 11822-0905_a5b861e0-8aeb-4cbd-897f-011f99d04299SPL ID a5b861e0-8aeb-4cbd-897f-011f99d04299SPL set ID 9f77adad-4b67-48c8-9ad4-24bccdea3ae2RxCUI 359818UNII 6M3C89ZY6RUPC 0011822090247
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

N411822090504 followed by a unit qualifier and the quantity

Package 11822-0905-04. 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 212056

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

FDA NDC Directory listings under ANDA 212056
ProductStrengthForm · routeLabelerProduct NDC
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralWalgreens0363-9610
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralWalgreens0363-9620

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