NDC codes

FDA NDC Directory
Product NDC (as listed)81963-101Labeler and product segments. Claims need a package NDC.
Product NDC at billing width81963-0101Add 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
81963-101-10819630101102 BOTTLE, DROPPER in 1 BOX (81963-101-10) / 15 mL in 1 BOTTLE, DROPPERMarketed from Sep 28, 2021

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)
Avenova Lubricant Eye Drops High Performance
Generic name (nonproprietary)
polyethylene glycol 400, propylene glycol
Active ingredients
Polyethylene glycol 400 — .4 g/100mLPropylene glycol — .3 g/100mL
Dosage form
Solution/ drops
Route
Ophthalmic
Product type
Over-the-counter drug
Marketing category
OTC monograph drugApplication M 018
Marketing start
Listing expires
Identifiers
Product ID 81963-101_474940b5-b173-6e9c-e063-6394a90a8b01SPL ID 474940b5-b173-6e9c-e063-6394a90a8b01SPL set ID cd17f037-5aa5-0ef8-e053-2a95a90a39cbRxCUI 477589UNII B697894SGQ, 6DC9Q167V3UPC 0857005004119

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

N481963010110 followed by a unit qualifier and the quantity

Package 81963-0101-10. 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 for the temporary relief of burning and irritation due to 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
ProductStrengthForm · routeLabelerProduct NDC
Rite Aid Hydration Lubricant Eye Dropspolyethylene glycol 400, propylene glycolPropylene glycol .3 g/100mL; Polyethylene glycol 400 .4 g/100mLSolution/ dropsOphthalmicRite Aid Corporation11822-0203
Sootheglycerin and propylene glycolGlycerin 6 mg/mL; Propylene glycol 6 mg/mLSolution/ dropsOphthalmicBausch & Lomb Incorporated24208-495
Family Wellness Original Redness Relief Eye Dropstetrahydrozoline hclTetrahydrozoline hydrochloride .05 g/100mLSolution/ dropsOphthalmicFamily Dollar Services, Inc.55319-907
Altachlore Sodium Chloride Hypertonicitysodium chlorideSodium chloride 50 mg/mLSolution/ dropsOphthalmicAltaire Pharmaceuticals Inc.59390-183
Vista Gonio Eye Lubricanthypromellose ophthalmic solutionHypromellose 2208 (100 mpa.s) 25 mg/15mLSolutionOphthalmicRed Wedding LLC77790-022
Archies Dry Eye Reliefpolyethylene glycol 400, propylene glycolPolyethylene glycol 400 .4 g/100mL; Propylene glycol .3 g/100mLSolution/ dropsOphthalmicArchie's Remedies83737-001
Revitalize Energizing Eye Dropsnaphazoline hydrochloride ,propylene glycolNaphazoline hydrochloride .03 g/100mL; Propylene glycol 1 g/100mLLiquidOphthalmicRevitalize Energy Inc.82864-001
Soothe XPlight mineral oil and mineral oilLight mineral oil 10 mg/mL; Mineral oil 45 mg/mLSolution/ dropsOphthalmicBausch & Lomb Incorporated24208-490
Xpect EyewasheyewashWater .984 mL/mLSolutionOphthalmicCintas Corporation42961-231
Family Wellness Advanced Redness Relief Eye Dropspolyethylene glycol 400, tetrahydrozoline hclPolyethylene glycol 400 1 g/100mL; Tetrahydrozoline hydrochloride .05 g/100mLSolution/ dropsOphthalmicFamily Dollar Services, Inc.55319-906
Eye Love Heyedrate Long Lasting Hydrationglycerin, povidonePovidone .25 g/100mL; Glycerin .63 g/100mLSolution/ dropsOphthalmicPhysician Recommended Neutraceuticals, L.P.83201-002
SilkTearsglycerin ophthalmic solutionGlycerin 2 mg/1000mLSolution/ dropsOphthalmicSilkTears85837-0001
Vis Guard Lubricant EyeOintment PMmineral oil, white petrolatum ointmentPetrolatum 830 mg/g; Light mineral oil 150 mg/gOintmentOphthalmicUlai Health LLC73057-510
Advanced Eye Relief Eye Washwater solutionWater 99.05 mL/100mLSolution/ dropsOphthalmicBausch & Lomb Incorporated24208-005
Exchange Select High Performance Lubricant Eye Dropspolyethylene glycol 400, propylene glycolPropylene glycol .3 g/100mL; Polyethylene glycol 400 .4 g/100mLSolution/ dropsOphthalmicArmy and Air Force Exchange Service55301-347
Sodium Chloride Normal Saltsodium chlorideSodium chloride 1 g/1TabletOralMethod Pharmaceuticals58657-118
Ancient Secrets Breathe Againsodium chlorideSodium chloride 20 mg/100mLAerosol, SprayNasalLOTUS BRANDS, INC.76328-100
Biotrue Hydration BoostglycerinGlycerin 5 mg/mLSolution/ dropsOphthalmicBausch & Lomb Incorporated24208-006
Sodium ChlorideSodium chloride 1 g/1TabletOralMethod Pharmaceuticals, LLC58657-119
CVS Lubricant Eye Drops Originalpolyethylene glycol 400, propylene glycolPolyethylene glycol 400 .4 g/100mL; Propylene glycol .3 g/100mLSolutionOphthalmicCVS69842-746

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