Walgreens Lubricant Eye Drops High Performance 15ml And Twin Pack Solution/ Drops
NDC Package 0363-4549-01

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Walgreens Lubricant Eye Drops High Performance 15ml And Twin Pack (polyethylene glycol 400, propylene glycol) solution/ dropses is ■ instill 1 to 2 drops in the affected eye(s) as needed■ children under 6 years of age: ask a doctor. This formulation utilizes a solution/ drops delivery system. Marketed by Walgreen Company, this product is identified by NDC 0363-4549 and is authorized under FDA application M018.

Identification & Billing

NDC Package Code
0363-4549-01
Package Description
1 BOTTLE, DROPPER in 1 BOX / 15 mL in 1 BOTTLE, DROPPER
Product Code
0363-4549
11-Digit Billing Format
00363454901
RxNorm Crosswalk
  • RxCUI: 477589 - polyethylene glycol 400, 0.4 % / propylene glycol 0.3 % Ophthalmic Solution
  • RxCUI: 477589 - polyethylene glycol 400 4 MG/ML / propylene glycol 3 MG/ML Ophthalmic Solution
  • RxCUI: 477589 - PEG 400 0.4 % / propylene glycol 0.3 % Ophthalmic Solution

Clinical Specifications

Proprietary Name
Walgreens Lubricant Eye Drops High Performance 15ml And Twin Pack
Non-Proprietary Name
Polyethylene Glycol 400, Propylene Glycol
Substance Name
Polyethylene Glycol 400; Propylene Glycol
Dosage Form
Solution/ Drops - A solution which is usually administered in a drop-wise fashion.
Administration Route
Ophthalmic - Administration to the external eye.
Active Ingredient(s)
Usage Information
■ instill 1 to 2 drops in the affected eye(s) as needed■ children under 6 years of age: ask a doctor

Regulatory & Marketing

Labeler Name
Walgreen Company
Product Type
Human Otc Drug
FDA Application #
M018
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
10-15-2019
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Other Available Packages

The following commercial packages are registered under the same Product NDC (0363-4549). Click a package code to view its specific billing and regulatory data.

0363-4549-02
2 BOTTLE, DROPPER in 1 BOX / 15 mL in 1 BOTTLE, DROPPER

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 0363-4549-01 identifies a specific commercial package of 1 bottle, dropper in 1 box / 15 ml in 1 bottle, dropper of Walgreens Lubricant Eye Drops High Performance 15ml And Twin Pack, a human over the counter drug labeled by Walgreen Company. This solution/ drops is formulated for ophthalmic use and contains polyethylene glycol 400; propylene glycol as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Walgreen Company on October 15, 2019. The current certification is valid through December 31, 2026.

How is this Walgreen Company product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 00363454901. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (4-4-2)
0363-4549-01
11-Digit CMS (5-4-2)
00363-4549-01

Note: The zero is added to the Labeler segment to maintain the 5-4-2 structure.