NDC codes

FDA NDC Directory
Product NDC (as listed)17856-0310Labeler and product segments. Claims need a package NDC.
Product NDC at billing width17856-0310Add 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
17856-0310-11785603100150 CUP, UNIT-DOSE in 1 CASE (17856-0310-1) / 2 g in 1 CUP, UNIT-DOSEMarketed from Jun 1, 2026
17856-0310-21785603100272 POUCH in 1 CASE (17856-0310-2) / 2 g in 1 POUCHMarketed from Mar 3, 2026

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)
Gavilax
Generic name (nonproprietary)
polyethylene glycol 3350
Active ingredients
Polyethylene glycol 3350 — 17 g/17g
Dosage form
Powder, For solution
Route
Oral
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 091077
Marketing start
Listing expires
Other FDA classes
Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers
Product ID 17856-0310_536f279a-56fc-0a05-e063-6294a90a2528SPL ID 536f279a-56fc-0a05-e063-6294a90a2528SPL set ID 4c207478-6f0f-c3cf-e063-6394a90aa4f2RxCUI 876193, 876214UNII G2M7P15E5P
Pharmacologic class
Osmotic Laxative

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

N417856031001 followed by a unit qualifier and the quantity

Package 17856-0310-01. 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 .

Indications (excerpt from the label)

Directions do not take more than directed unless advised by your doctor the bottle top is a measuring cap marked to contain 17 grams of powder when filled to the indicated line. adults and children 17 years of age and older: use once a day fill to top of line in cap which is marked to indicate the correct dose (17 g) stir and dissolve in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink do not combine with starch-based thickeners used for difficulty swallowing ensure that the powder is fully dissolved before drinking do not drink if there are any clumps do not use more than 7 days children 16 years of age or under: ask a doctor Other Information store at 20°- 25°C (68°…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 091077

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

FDA NDC Directory listings under ANDA 091077
ProductStrengthForm · routeLabelerProduct NDC
Gavilaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralA-S Medication Solutions50090-5310
Polyethylene GlycolPolyethylene glycol 3350 17 g/17gPowder, For suspensionOralBluePoint Laboratories68001-505
Gavilaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralProficient Rx LP63187-368
Gavilaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralPreferred Pharmaceuticals, Inc.68788-7508
Gavilaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralLupin Pharmaceuticals,Inc.43386-312
Gavilaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralATLANTIC BIOLOGICALS CORP.17856-0312

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