NDC codes

FDA NDC Directory
Product NDC (as listed)69842-216Labeler and product segments. Claims need a package NDC.
Product NDC at billing width69842-0216Add 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
69842-216-156984202161520 BLISTER PACK in 1 CARTON (69842-216-15) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from May 1, 2016
69842-216-1669842021616160 BLISTER PACK in 1 CARTON (69842-216-16) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from May 1, 2016
69842-216-4469842021644100 BLISTER PACK in 1 CARTON (69842-216-44) / 1 GUM, CHEWING in 1 BLISTER PACKMarketed from May 1, 2016

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)
Nicotine Polacrilex coated ice mintSuffix: coated ice mint
Generic name (nonproprietary)
nicotine polacrilex
Active ingredients
Nicotine — 2 mg/1
Dosage form
Gum, Chewing
Route
Buccal
Labeler
CVS PharmacyNDC labeler code 69842
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 204794
Marketing start
Listing expires
Other FDA classes
Nicotine (Chemical structure)
Identifiers
Product ID 69842-216_5f0324e3-b546-4cdc-af4d-e45e2052a179SPL ID 5f0324e3-b546-4cdc-af4d-e45e2052a179SPL set ID e4e3fd5f-1ed1-4a18-9c31-7224cae77dedRxCUI 311975, 314119UNII 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. Buccal products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N469842021615 followed by a unit qualifier and the quantity

Package 69842-0216-15. 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)

About NDC 69842-216

What is NDC 69842-216?
69842-216 is the product NDC for Nicotine Polacrilex coated ice mint, Nicotine 2 mg/1 gum, chewing, listed with the FDA by CVS Pharmacy. It has 3 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Nicotine Polacrilex coated ice mint (Nicotine Polacrilex).
What is the active ingredient?
Nicotine.
Who is the labeler?
CVS Pharmacy, NDC labeler code 69842. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Nicotine Polacrilex coated ice mint?
5 other product NDCs are listed under this name. See all Nicotine Polacrilex coated ice mint NDCs.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Nicotine Polacrilex coated ice mint NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Nicotine Polacrilex Coated Ice Mintnicotine polacrilexNicotine 4 mg/1Gum, ChewingBuccalCARDINAL HEALTH 110, LLC. DBA LEADER 7000070000-034470000-0344-0170000-0344-02
Nicotine Polacrilex Coated Ice Mintnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalCARDINAL HEALTH 110, LLC. DBA LEADER 7000070000-034870000-0348-0170000-0348-02
Nicotine Polacrilex coated ice mintnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalAmerisourceBergen (Good Neighbor Pharmacy) 4612246122-44846122-0448-58
Nicotine Polacrilex coated ice mintnicotine polacrilexNicotine 4 mg/1Gum, ChewingBuccalAmerisourceBergen (Good Neighbor Pharmacy) 4612246122-44946122-0449-58
Nicotine Polacrilex coated ice mintnicotine polacrilex gumNicotine 4 mg/1Gum, ChewingBuccalCVS Pharmacy69842-21769842-0217-1569842-0217-1669842-0217-44

Other NDCs under ANDA 204794

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

FDA NDC Directory listings under ANDA 204794
ProductStrengthForm · routeLabelerProduct NDC
Nicotine PolacrilexNicotine 2 mg/1Gum, ChewingBuccalWalgreens0363-9260
Nicotine PolacrilexNicotine 2 mg/1Gum, ChewingBuccalChain Drug Consortium, LLC68016-292
Nicotine Polacrilex coated ice mintnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalAmerisourceBergen (Good Neighbor Pharmacy) 4612246122-448
Nicotine Polacrilex Coated Ice Mintnicotine polacrilexNicotine 2 mg/1Gum, ChewingBuccalCARDINAL HEALTH 110, LLC. DBA LEADER 7000070000-0348

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