Over-the-counter drug · ANDA

rugby PEG 3350 (Polyethylene glycol 3350) NDC 72162-2155

Polyethylene glycol 3350 17 g/17g · Powder, For solution · Oral · Bryant Ranch Prepack

NDC codes

FDA NDC Directory
Product NDC (as listed)72162-2155Labeler and product segments. Claims need a package NDC.
Product NDC at billing width72162-2155Add 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
72162-2155-272162215502238 g in 1 BOTTLE (72162-2155-2)Marketed from Jan 5, 2015
72162-2155-472162215504510 g in 1 BOTTLE (72162-2155-4)Marketed from Jan 5, 2015

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)
rugby PEG 3350
Generic name (nonproprietary)
polyethylene glycol 3350
Active ingredients
Polyethylene glycol 3350 — 17 g/17g
Dosage form
Powder, For solution
Route
Oral
Labeler
Bryant Ranch PrepackNDC labeler code 72162
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 090685
Marketing start
Listing expires
Other FDA classes
Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers
Product ID 72162-2155_fb3f889c-7f88-4850-9994-d436f9010990SPL ID fb3f889c-7f88-4850-9994-d436f9010990SPL set ID fb3f889c-7f88-4850-9994-d436f9010990RxCUI 876193UNII 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

N472162215502 followed by a unit qualifier and the quantity

Package 72162-2155-02. 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 • relieves occasional constipation (irregularity) • generally produces a bowel movement in 1 to 3 days

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 72162-2155

What is NDC 72162-2155?
72162-2155 is the product NDC for rugby PEG 3350 (polyethylene glycol 3350), Polyethylene glycol 3350 17 g/17g powder, for solution, listed with the FDA by Bryant Ranch Prepack. It has 2 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
rugby PEG 3350 (Polyethylene glycol 3350).
What is the active ingredient?
Polyethylene glycol 3350.
Who is the labeler?
Bryant Ranch Prepack, NDC labeler code 72162. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for rugby PEG 3350?
1 other product NDC are listed under this name. See all rugby PEG 3350 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 rugby PEG 3350 NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
rugby PEG 3350polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralRugby Laboratories0536-105200536-1052-2400536-1052-2700536-1052-60+1 more

Other NDCs under ANDA 090685

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

FDA NDC Directory listings under ANDA 090685
ProductStrengthForm · routeLabelerProduct NDC
injoy constipation reliefpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralL. Perrigo Company0113-6900
MiraLAX Orange Flavorpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralBayer HealthCare LLC.11523-0122
Good Neighbor Pharmacy ClearLaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralAmerisource Bergen46122-014
purelaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCVS Pharmacy69842-458
foster and thrive clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralStrategic Sourcing Services LLC70677-1109
careone clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralRetail Business Services, LLC72476-723
rugby PEG 3350polyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralRugby Laboratories0536-1052
good sense clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralL. Perrigo Company0113-1023
equaline clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralUnited Natural Foods, Inc. dba UNFI41163-306
clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralMeijer, Inc.79481-0090
clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralH E B59640-797
clearlaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralPublix Super Markets Inc56062-306
Good Sense Clear Laxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralProficient Rx LP71205-447
clear laxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralMeijer Distribution Inc41250-306
Welby ClearLaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralAldi, Inc64024-306
gentle laxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralKroger Company30142-306
Polyethylene Glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralA-S Medication Solutions50090-2430
Leader ClearLaxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralCardinal Health 110, LLC. dba Leader70000-0704
Good Sense Clear Laxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralL. Perrigo Company0113-0306
equate clear laxpolyethylene glycol 3350Polyethylene glycol 3350 17 g/17gPowder, For solutionOralWal-Mart Stores Inc49035-306

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