Cvs Lubricant Eye Drops Original Solution
NDC Package 69842-746-01

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

Package Information

Cvs Lubricant Eye Drops Original (polyethylene glycol 400, propylene glycol) solution is usefor the temporary relief of burning and irritation of the eye due to dryness of the eye. This formulation utilizes a solution delivery system. Marketed by Cvs, this product is identified by NDC 69842-746 and is authorized under FDA application M018.

Identification & Billing

NDC Package Code
69842-746-01
Package Description
30 VIAL, DISPENSING in 1 CARTON / .4 mL in 1 VIAL, DISPENSING
Product Code
69842-746
11-Digit Billing Format
69842074601
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
Cvs Lubricant Eye Drops Original
Non-Proprietary Name
Polyethylene Glycol 400, Propylene Glycol
Substance Name
Polyethylene Glycol 400; Propylene Glycol
Dosage Form
Solution - A clear, homogeneous liquid1 dosage form that contains one or more chemical substances dissolved in a solvent or mixture of mutually miscible solvents.
Administration Route
Ophthalmic - Administration to the external eye.
Active Ingredient(s)
Usage Information
Usefor the temporary relief of burning and irritation of the eye due to dryness of the eye

Regulatory & Marketing

Labeler Name
Cvs
Product Type
Human Otc Drug
FDA Application #
M018
Marketing Category
OTC MONOGRAPH DRUG -
Start Marketing Date
02-12-2021
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 69842-746-01 identifies a specific commercial package of 30 vial, dispensing in 1 carton / .4 ml in 1 vial, dispensing of Cvs Lubricant Eye Drops Original, a human over the counter drug labeled by Cvs. This solution 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 Cvs on February 12, 2021. The current certification is valid through December 31, 2026.

How is this Cvs product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69842074601. 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)
69842-746-01
11-Digit CMS (5-4-2)
69842-0746-01

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