NDC codes

FDA NDC Directory
Product NDC (as listed)50804-110Labeler and product segments. Claims need a package NDC.
Product NDC at billing width50804-0110Add 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
50804-110-0150804011001508040110011 BOTTLE, DROPPER in 1 BOX (50804-110-01) / 15 mL in 1 BOTTLE, DROPPERMarketed from Jan 2, 2020

How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 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)
Good Sense Artificial Tears
Generic name (nonproprietary)
polyvinyl alcohol, povidone
Active ingredients
Polyvinyl alcohol, Unspecified — .5 g/100mLPovidone — .6 g/100mL
Dosage form
Solution
Route
Ophthalmic
Labeler
Geiss, Destin & Dunn, Inc.NDC labeler code 50804
Product type
Over-the-counter drug
Marketing category
OTC monograph drugApplication M 018
Marketing start
Listing expires
Identifiers
Product ID 50804-110_47450941-e9fd-623c-e063-6294a90a940bSPL ID 47450941-e9fd-623c-e063-6294a90a940bSPL set ID 9b243301-2e4b-5706-e053-2995a90a9b90RxCUI 598050UNII 532B59J990, FZ989GH94EUPC 0180410000163

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. Ophthalmic products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N450804011001 followed by a unit qualifier and the quantity

Package 50804-0110-01. 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)

Uses for use as a protectant against further irritation or to relieve dryness of the eye for the temporary relief of discomfort due to minor irritations of the eye, or to exposure to wind or sun

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 50804-110

What is NDC 50804-110?
50804-110 is the product NDC for Good Sense Artificial Tears, Polyvinyl alcohol, Unspecified .5 g/100mL; Povidone .6 g/100mL solution, listed with the FDA by Geiss, Destin & Dunn, Inc.. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Good Sense Artificial Tears (Polyvinyl alcohol, povidone).
What is the active ingredient?
Polyvinyl alcohol, Unspecified, Povidone.
Who is the labeler?
Geiss, Destin & Dunn, Inc., NDC labeler code 50804. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Good Sense Artificial Tears?
None: this is the only finished product listed under this name.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

Other NDCs under M 018

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

FDA NDC Directory listings under M 018
ProductStrengthForm · routeLabelerProduct NDC
Walgreens Eye Drops Maximum Redness Relief 15mLglycerin, naphazoline hciNaphazoline hydrochloride .03 g/100mL; Glycerin .5 g/100mLSolution/ dropsOphthalmicWalgreen Company0363-4546
Vista Gonio Eye Lubricanthypromellose ophthalmic solutionHypromellose 2208 (100 mpa.s) 25 mg/15mLSolutionOphthalmicRed Wedding LLC77790-022
Capasil Pain Relievingmenthol, methyl salicylateMethyl salicylate 100 mg/mL; Menthol 20 mg/mLCreamTopicalPureTek Corporation59088-434
Rugby Eye Washwater, purifiedWater 99.05 g/100mLSolutionOphthalmicA-S Medication Solutions50090-7440
DG Original Eye Dropstetrahydrozoline hclTetrahydrozoline hydrochloride .05 g/100mLSolutionOphthalmicDolgencorp LLC55910-363
TopCare Health Lubricant Eye Dropscarboxymethylcellulose sodiumCarboxymethylcellulose sodium .5 g/100mLSolution/ dropsOphthalmicTopcare Associates LLC76162-089
VitaPhyte Lubricating Eye Dropslubricating eye dropsCarboxymethylcellulose sodium 5 mg/mL; Glycerin 3 mg/mLSolutionOphthalmicGuangzhou Liyan Cosmetics Technology Co., Ltd.87770-008
VISTA Hypromellose Dry Eye ReliefhypromelloseHypromellose 2910 (50 mpa.s) .3 g/mLGelOphthalmicRed Wedding LLC77790-002
EyS Eye WashwaterWater 14.85 mL/15mLSolutionOphthalmicEyes-Plus LLC57349-220
DG Health Advanced Relief Eye Dropsdextran 70, polyethylene glycol 400, povidone, tetrahydrozoline hclPovidone, Unspecified 1 g/100mL + 3 more ingredientsSolutionOphthalmicDolgencorp LLC55910-361
Fendall 2000 Pure Flowpurified waterWater 98.6 L/100LLiquidOphthalmicHoneywell Safety Products USA, Inc.0498-0631
VISTA MEIBO TEARS Propylene Glycol 0.6% w/v Advanced Dry Eye Relief Lubricating Drops 10 mlpropylene glycolPropylene glycol .6 g/100mLLiquidOphthalmicRed Wedding LLC77790-003
VitaPhyte Lubricant Eye Dropslubricant eye dropsCarboxymethylcellulose sodium 5 mg/mL; Glycerin 3 mg/mLSolutionOphthalmicGuangzhou Liyan Cosmetics Technology Co., Ltd.87770-020
DG Health Dry Eye Reliefglycerin, hypromellose, polypropylene glycol 400Polyethylene glycol 400 1 g/100mL + 2 more ingredientsSolutionOphthalmicDolgencorp LLC55910-362
OptaseglycerinGlycerin 2 mg/mLSolution/ dropsOphthalmicScope Health Inc72972-002
Rippleglycerin, povidoneGlycerin .63 g/100mL; Povidone .25 g/100mLSolution/ dropsOphthalmicCorneaCare Inc82875-003
SalinenasalSodium chloride 6.5 mg/mLSprayNasalGERI-CARE PHARMACEUTICAL CORP57896-333
Signature Care Lubricant Eye Dropscarboxymethylcellulose sodiumCarboxymethylcellulose sodium .5 g/100mLSolution/ dropsOphthalmicBetter Living Brands LLC21130-705
OptaseglycerinGlycerin 1 mg/mLSprayOphthalmicScope Health Inc72972-001
Discount Drug Mart Eye Drops Multi-Symptom Reliefpolyethylene glycol 400, tetrahydrozoline hcl, zinc sulfateZinc sulfate .25 g/100mL + 2 more ingredientsSolution/ dropsOphthalmicDiscount Drug Mart, Inc.53943-490

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