NDC 55301-177

NDC codes

FDA NDC Directory

Product NDC (as listed)55301-177Labeler and product segments. Claims need a package NDC.

Product NDC at billing width55301-0177Add 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
55301-177-01	55301017701	1 BOTTLE, DROPPER in 1 CARTON (55301-177-01) / 15 mL in 1 BOTTLE, DROPPERMarketed from Feb 12, 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): Exchange Select Eye Drops Advanced Relief Moisturizer
Generic name (nonproprietary): dextran 70, polyethylene glycol 400, povidone, tetrahydrozoline hcl
Active ingredients: Polyethylene glycol 400 — 1 g/100mLTetrahydrozoline hydrochloride — .05 g/100mLPovidone, Unspecified — 1 g/100mLDextran 70 — .1 g/100mL
Dosage form: Solution
Route: Ophthalmic
Labeler: Army and Air Force Exchange Service
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 018
Marketing start: Feb 12, 2020
Listing expires: Dec 31, 2026
Other FDA classes: Increased Intravascular Volume (Physiologic effect)Osmotic Activity (Mechanism)
Identifiers: Product ID 55301-177_47451eaa-897e-aa74-e063-6394a90ae040SPL ID 47451eaa-897e-aa74-e063-6394a90ae040SPL set ID 9e475240-2df1-9bee-e053-2995a90a8d4bRxCUI 996202UNII B697894SGQ, 0YZT43HS7D, FZ989GH94E, 7SA290YK68
Pharmacologic class: Plasma Volume Expander

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

N455301017701 followed by a unit qualifier and the quantity

Package 55301-0177-01. 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 Dec 30, 2025.

Indications (excerpt from the label)

Uses relieves redness of the eye due to minor eye irritations as a lubricant to prevent further irritation or to relieve dryness of the eye

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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
Product	Strength	Form · route	Labeler	Product NDC
Rite Aid Hydration Lubricant Eye Dropspolyethylene glycol 400, propylene glycol	Propylene glycol .3 g/100mL; Polyethylene glycol 400 .4 g/100mL	Solution/ dropsOphthalmic	Rite Aid Corporation	11822-0203
Sootheglycerin and propylene glycol	Glycerin 6 mg/mL; Propylene glycol 6 mg/mL	Solution/ dropsOphthalmic	Bausch & Lomb Incorporated	24208-495
Family Wellness Original Redness Relief Eye Dropstetrahydrozoline hcl	Tetrahydrozoline hydrochloride .05 g/100mL	Solution/ dropsOphthalmic	Family Dollar Services, Inc.	55319-907
Altachlore Sodium Chloride Hypertonicitysodium chloride	Sodium chloride 50 mg/mL	Solution/ dropsOphthalmic	Altaire Pharmaceuticals Inc.	59390-183
Vista Gonio Eye Lubricanthypromellose ophthalmic solution	Hypromellose 2208 (100 mpa.s) 25 mg/15mL	SolutionOphthalmic	Red Wedding LLC	77790-022
Archies Dry Eye Reliefpolyethylene glycol 400, propylene glycol	Polyethylene glycol 400 .4 g/100mL; Propylene glycol .3 g/100mL	Solution/ dropsOphthalmic	Archie's Remedies	83737-001
Revitalize Energizing Eye Dropsnaphazoline hydrochloride ,propylene glycol	Naphazoline hydrochloride .03 g/100mL; Propylene glycol 1 g/100mL	LiquidOphthalmic	Revitalize Energy Inc.	82864-001
Soothe XPlight mineral oil and mineral oil	Light mineral oil 10 mg/mL; Mineral oil 45 mg/mL	Solution/ dropsOphthalmic	Bausch & Lomb Incorporated	24208-490
Xpect Eyewasheyewash	Water .984 mL/mL	SolutionOphthalmic	Cintas Corporation	42961-231
Family Wellness Advanced Redness Relief Eye Dropspolyethylene glycol 400, tetrahydrozoline hcl	Polyethylene glycol 400 1 g/100mL; Tetrahydrozoline hydrochloride .05 g/100mL	Solution/ dropsOphthalmic	Family Dollar Services, Inc.	55319-906
Eye Love Heyedrate Long Lasting Hydrationglycerin, povidone	Povidone .25 g/100mL; Glycerin .63 g/100mL	Solution/ dropsOphthalmic	Physician Recommended Neutraceuticals, L.P.	83201-002
SilkTearsglycerin ophthalmic solution	Glycerin 2 mg/1000mL	Solution/ dropsOphthalmic	SilkTears	85837-0001
Vis Guard Lubricant EyeOintment PMmineral oil, white petrolatum ointment	Petrolatum 830 mg/g; Light mineral oil 150 mg/g	OintmentOphthalmic	Ulai Health LLC	73057-510
Advanced Eye Relief Eye Washwater solution	Water 99.05 mL/100mL	Solution/ dropsOphthalmic	Bausch & Lomb Incorporated	24208-005
Exchange Select High Performance Lubricant Eye Dropspolyethylene glycol 400, propylene glycol	Propylene glycol .3 g/100mL; Polyethylene glycol 400 .4 g/100mL	Solution/ dropsOphthalmic	Army and Air Force Exchange Service	55301-347
Sodium Chloride Normal Saltsodium chloride	Sodium chloride 1 g/1	TabletOral	Method Pharmaceuticals	58657-118
Ancient Secrets Breathe Againsodium chloride	Sodium chloride 20 mg/100mL	Aerosol, SprayNasal	LOTUS BRANDS, INC.	76328-100
Biotrue Hydration Boostglycerin	Glycerin 5 mg/mL	Solution/ dropsOphthalmic	Bausch & Lomb Incorporated	24208-006
Sodium Chloride	Sodium chloride 1 g/1	TabletOral	Method Pharmaceuticals, LLC	58657-119
CVS Lubricant Eye Drops Originalpolyethylene glycol 400, propylene glycol	Polyethylene glycol 400 .4 g/100mL; Propylene glycol .3 g/100mL	SolutionOphthalmic	CVS	69842-746

Showing 20 of 40.

Exchange Select Eye Drops Advanced Relief Moisturizer NDC 55301-177