NDC codes

FDA NDC Directory
Product NDC (as listed)79903-101Labeler and product segments. Claims need a package NDC.
Product NDC at billing width79903-0101Add 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
79903-101-20799030101201 CONTAINER in 1 CARTON (79903-101-20) / 20 LOZENGE in 1 CONTAINERMarketed from Jan 11, 2022
79903-101-407990301014040 LOZENGE in 1 CONTAINER (79903-101-40)Marketed from Nov 15, 2023
79903-101-80799030101802 CONTAINER in 1 CARTON (79903-101-80) / 40 LOZENGE in 1 CONTAINERMarketed from Jan 11, 2022

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)
euqate nicotine
Generic name (nonproprietary)
nicotine polacrilex
Active ingredients
Nicotine — 2 mg/1
Dosage form
Lozenge
Route
Oral
Product type
Over-the-counter drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 077007
Marketing start
Listing expires
Other FDA classes
Nicotine (Chemical structure)
Identifiers
Product ID 79903-101_012bcc52-fb21-4b53-9bed-aa144d6d9ee3SPL ID 012bcc52-fb21-4b53-9bed-aa144d6d9ee3SPL set ID c1764aad-1da4-4e4e-b6b0-5a3df1edda85RxCUI 359817UNII 6M3C89ZY6RUPC 0012345678905
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. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N479903010120 followed by a unit qualifier and the quantity

Package 79903-0101-20. 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)

Other NDCs under ANDA 077007

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

FDA NDC Directory listings under ANDA 077007
ProductStrengthForm · routeLabelerProduct NDC
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralHyVee Inc42507-344
nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralWalgreen Company0363-7044
nicotine polacrilexnicotineNicotine 4 mg/1LozengeOralH E B37808-948
Good Sense Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralL. Perrigo Company0113-2502
nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralSixarp, LLC59368-463
nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralAmazon.com Services LLC72288-651
good sense nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralA-S Medication Solutions50090-7060
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralCVS WOONSOCKET PRESCRIPTION CENTER, INCORPORATED51316-787
Good Sense Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralA-S Medication Solutions50090-7061
careone nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralAmerican Sales Company41520-701
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralHyVee Inc42507-690
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralCVS Pharmacy59779-344
kirkland signature quit 2nicotine polacrilexNicotine 2 mg/1LozengeOralCostco Wholesale Company63981-344
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralRite Aid Corporation11822-0344
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralSafeway21130-636
exchange select nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralArmy & Air Force Exchange Service55301-873
Nicotinenicotine polacrilexNicotine 4 mg/1LozengeOralKroger Company30142-873
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralH E B59640-099
Nicotinenicotine polacrilexNicotine 2 mg/1LozengeOralCVS WOONSOCKET PRESCRIPTION CENTER, INCORPORATED51316-319
kirkland signature quit 4nicotine polacrilexNicotine 4 mg/1LozengeOralCostco Wholesale Company63981-873

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