NDC codes

FDA NDC Directory
Product NDC (as listed)0409-1775Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00409-1775Add 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
0409-1775-100040917751010 CARTON in 1 PACKAGE (0409-1775-10) / 1 SYRINGE, PLASTIC in 1 CARTON / 10 mL in 1 SYRINGE, PLASTIC (0409-1775-40)Marketed from Feb 22, 2006

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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)
Dextrose
Generic name (nonproprietary)
dextrose monohydrate
Active ingredients
Dextrose monohydrate — 250 mg/mL
Dosage form
Injection, Solution
Route
Intravenous
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 019445
Marketing start
Listing expires
Identifiers
Product ID 0409-1775_8ef5055d-1ca7-42b8-81bd-ecfcf303173bSPL ID 8ef5055d-1ca7-42b8-81bd-ecfcf303173bSPL set ID 672264e3-9709-4bba-2a9d-12bf70c7396aRxCUI 727518UNII LX22YL083G

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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N400409177510 followed by a unit qualifier and the quantity

Package 00409-1775-10. 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)

Dextrose Injection (25%) is indicated for the treatment of acute symptomatic episodes of hypoglycemia in pediatric patients from birth up to 2 years of age. Dextrose Injection (25%) is indicated for the treatment of acute symptomatic episodes of hypoglycemia in pediatric patients younger than 2 years old. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 019445

Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.

FDA NDC Directory listings under NDA 019445
ProductStrengthForm · routeLabelerProduct NDC
Dextrosedextrose monohydrateDextrose monohydrate 250 mg/mLInjection, SolutionIntravenousREMEDYREPACK INC.70518-4452
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousREMEDYREPACK INC.70518-4219
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousHospira, Inc.0409-7517
Dextrosedextrose monohydrateDextrose monohydrate 250 mg/mLInjection, SolutionIntravenousMedical Purchasing Solutions, LLC71872-7214
25% Dextrose InfantDextrose monohydrate 250 mg/mLInjection, SolutionIntravenousHF Acquisition Co. LLC, DBA Health First51662-1213
DextroseDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousHF Acquisition Co LLC, DBA HealthFirst51662-1215
50% DextroseDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousHF Acquisition Co LLC, DBA HealthFirst51662-1216
Infant DextrosedextroseDextrose monohydrate 250 mg/mLInjection, SolutionIntravenousHenry Schein, Inc.0404-9844
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousHenry Schein, Inc.0404-9845
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousHenry Schein, Inc.0404-9847
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousMedical Purchasing Solutions, LLC71872-7003
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousProPharma Distribution84549-517
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousMedical Purchasing Solutions, LLC71872-7057
Dextrosedextrose monohydrateDextrose monohydrate 25 g/50mLInjection, SolutionIntravenousHospira, Inc.0409-6648

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