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  5. NDC Package Code: 0904-6931-76 Polyethylene Glycol 3350

NDC Package 0904-6931-76 Polyethylene Glycol 3350

Powder, For Solution Oral - View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Find all the important details about this NDC Package code, including the 11-Digit NDC Billing number, billing units, wholesale price, RxNorm crosswalk, active ingredients, pharmacologic clasess, etc.

NDC Package Code:
0904-6931-76
Package Description:
30 PACKET in 1 CARTON / 17 g in 1 PACKET
Product Code:
0904-6931
Proprietary Name:
Polyethylene Glycol 3350
Non-Proprietary Name:
Polyethylene Glycol 3350
Substance Name:
Polyethylene Glycol 3350
Usage Information:
This medication is used to treat occasional constipation. It works by holding water in the stool to soften the stool and increases the number of bowel movements. It is known as an osmotic-type laxative. This medication is also available without a prescription. If you are taking this medication for self-treatment, it is important to read the manufacturer's package instructions carefully so you know when to consult your doctor or pharmacist. (See also Precautions.)
11-Digit NDC Billing Format:
00904693176
Billing Unit:
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
NDC to RxNorm Crosswalk:
1 EA
NDC to RxNorm Crosswalk:
  • RxCUI: 876193 - polyethylene glycol 3350 17 GM Powder for Oral Solution
  • RxCUI: 876193 - polyethylene glycol 3350 17000 MG Powder for Oral Solution
    • Product Type:
    Human Otc Drug
    Labeler Name:
    Major Pharmaceuticals
    Dosage Form:
    Powder, For Solution - An intimate mixture of dry, finely divided drugs and/or chemicals, which, upon the addition of suitable vehicles, yields a solution.
    Administration Route(s):
  • Oral - Administration to or by way of the mouth.
    • Active Ingredient(s):
  • POLYETHYLENE GLYCOL 3350 17 g/17g
    • Pharmacologic Class(es):
  • Osmotic Activity - [MoA] (Mechanism of Action)
  • Osmotic Laxative - [EPC] (Established Pharmacologic Class)
  • Stimulation Large Intestine Fluid/Electrolyte Secretion - [PE] (Physiologic Effect)
    • Sample Package:
    No
    FDA Application Number:
    ANDA203928
    Marketing Category:
    ANDA - A product marketed under an approved Abbreviated New Drug Application.
    Start Marketing Date:
    06-30-2019
    Listing Expiration Date:
    12-31-2024
    Exclude Flag:
    N
    Code Structure:

    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 disclaimer below.

    Other Product Packages

    The following packages are also available for this product:

    NDC Package CodePackage Description
    0904-6931-2614 PACKET in 1 CARTON / 17 g in 1 PACKET
    0904-6931-81100 PACKET in 1 CARTON / 17 g in 1 PACKET
    0904-6931-8617 g in 1 PACKET

    * Please review the disclaimer below.

    Frequently Asked Questions

    What is NDC 0904-6931-76?

    The NDC Packaged Code 0904-6931-76 is assigned to a package of 30 packet in 1 carton / 17 g in 1 packet of Polyethylene Glycol 3350, a human over the counter drug labeled by Major Pharmaceuticals. The product's dosage form is powder, for solution and is administered via oral form.

    Is NDC 0904-6931 included in the NDC Directory?

    Yes, Polyethylene Glycol 3350 with product code 0904-6931 is active and included in the NDC Directory. The product was first marketed by Major Pharmaceuticals on June 30, 2019 and its listing in the NDC Directory is set to expire on December 31, 2024 if the product is not updated or renewed by the manufacturer.

    What is the NDC billing unit for package 0904-6931-76?

    The contents of this package are billed per "each", products billed on a per each basis are usually products dispensed in discreet units. The calculated billable units for this package is 1.

    What is the 11-digit format for NDC 0904-6931-76?

    The 11-digit format is 00904693176. The 11-digit billing format might be required by the Centers for Medicare & Medicaid Services (CMS) and other payers in billing claim forms.

    This package code is originally configured in a 4-4-2 segment 10-digit format and by adding a zero within the original NDC package code we can obtain the converted 11-digit format in a 5-4-2 segment configuration. The table below shows the 11-digit code conversion:

    10-Digit Format10-Digit Original Code11-Digit Format11-Digit Code
    4-4-20904-6931-765-4-200904-6931-76