Good Neighbor Pharmacy Clearlax Powder, For Solution
NDC Package 46122-014-33

11-digit billing NDC: 46122001433 · Billing unit: GM · 238 GM per package
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Good Neighbor Pharmacy Clearlax (polyethylene glycol 3350) powders is •do not take more than directed unless advised by your doctor•the bottle top is a measuring cap marked to contain 17 grams of powder when filled to the indicated line (white section in cap)•adults and children 17 years of age and older:•use once a day•fill to top of white section in cap which is marked to indicate the correct dose (17 g)•stir and dissolve in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink•do not combine with starch-based thickeners used for difficulty swallowing•ensure that the powder is fully dissolved before drinking•do not drink if there are any clumps•do not use no more than 7 days•children 16 years of age or under: ask a doctor. This formulation utilizes a powder, for solution delivery system. Marketed by Amerisource Bergen, this product is identified by NDC 46122-014 and is authorized under FDA application ANDA090685.

Identification & Billing

NDC Package Code
46122-014-33
Package Description
238 g in 1 BOTTLE
Product Code
46122-014
11-Digit Billing Format
46122001433
Billing Unit
GM - Billing unit of "gram" is used when a product is measured by its weight.
Units Per Package
238 GM
RxNorm Crosswalk
  • RxCUI: 876193 - polyethylene glycol 3350 17 GM Powder for Oral Solution
  • RxCUI: 876193 - polyethylene glycol 3350 17000 MG Powder for Oral Solution
  • RxCUI: 880407 - ClearLax 17 GM Powder for Oral Solution
  • RxCUI: 880407 - polyethylene glycol 3350 17000 MG Powder for Oral Solution [ClearLax]

Clinical Specifications

Proprietary Name
Good Neighbor Pharmacy Clearlax
Non-Proprietary Name
Polyethylene Glycol 3350
Substance Name
Polyethylene Glycol 3350
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
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
POLYETHYLENE GLYCOL 3350 17 g/17g
Pharmacologic Class
Usage Information
•do not take more than directed unless advised by your doctor•the bottle top is a measuring cap marked to contain 17 grams of powder when filled to the indicated line (white section in cap)•adults and children 17 years of age and older:•use once a day•fill to top of white section in cap which is marked to indicate the correct dose (17 g)•stir and dissolve in any 4 to 8 ounces of beverage (cold, hot or room temperature) then drink•do not combine with starch-based thickeners used for difficulty swallowing•ensure that the powder is fully dissolved before drinking•do not drink if there are any clumps•do not use no more than 7 days•children 16 years of age or under: ask a doctor

Regulatory & Marketing

Labeler Name
Amerisource Bergen
Product Type
Human Otc Drug
FDA Application #
ANDA090685
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
10-19-2009
Listing Expiration
12-31-2027
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 (46122-014). Click a package code to view its specific billing and regulatory data.

46122-014-31
119 g in 1 BOTTLE
46122-014-38
289 g in 1 BOTTLE
46122-014-52
10 PACKET in 1 CARTON / 17 g in 1 PACKET
46122-014-71
510 g in 1 BOTTLE

* 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 46122-014-33 identifies a specific commercial package of 238 g in 1 bottle of Good Neighbor Pharmacy Clearlax, a human over the counter drug labeled by Amerisource Bergen. This powder, for solution is formulated for oral use and contains polyethylene glycol 3350 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 Amerisource Bergen on October 19, 2009. The current certification is valid through December 31, 2027.

How is this Amerisource Bergen product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 46122001433. Quantities are measured in per "gm or gram", products billed per gram are products measured by weight.. There are 238 total billable units per package. 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 (5-3-2)
46122-014-33
11-Digit CMS (5-4-2)
46122-0014-33

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