NDC codes

FDA NDC Directory
Product NDC (as listed)0904-6575Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00904-6575Add 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
0904-6575-6100904657561100 BLISTER PACK in 1 CARTON (0904-6575-61) / 1 TABLET in 1 BLISTER PACKMarketed from Feb 1, 2003

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)
Phenobarbital
Generic name (nonproprietary)
phenobarbital
Active ingredients
Phenobarbital — 32.4 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Marketing end
DEA schedule
CIV
Identifiers
Product ID 0904-6575_36cbae84-9974-4169-b168-f71f2dfba1e6SPL ID 36cbae84-9974-4169-b168-f71f2dfba1e6SPL set ID e024b80b-c22f-44bc-b273-f9398f840ed0RxCUI 199167UNII YQE403BP4D

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 HCPCS code in Med-Code's directory. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N400904657561 followed by a unit qualifier and the quantity

Package 00904-6575-61. 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)

INDICATIONS AND USAGE 1. Sedative 2. Anticonvulsant – For the treatment of generalized and partial seizures.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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