NDC codes

FDA NDC Directory
Product NDC (as listed)0904-7470Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00904-7470Add 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
0904-7470-010090474700130 CUP, UNIT-DOSE in 1 CASE (0904-7470-01) / 10 mL in 1 CUP, UNIT-DOSE (0904-7470-66)Marketed from Jun 26, 2024
0904-7470-180090474701840 CUP, UNIT-DOSE in 1 CASE (0904-7470-18) / 10 mL in 1 CUP, UNIT-DOSE (0904-7470-66)Marketed from Jun 26, 2024
0904-7470-560090474705620 CUP, UNIT-DOSE in 1 CASE (0904-7470-56) / 10 mL in 1 CUP, UNIT-DOSE (0904-7470-66)Marketed from Jun 26, 2024
0904-7470-660090474706610 mL in 1 CUP, UNIT-DOSE (0904-7470-66)Marketed from Jun 26, 2024
0904-7470-7200904747072100 CUP, UNIT-DOSE in 1 CASE (0904-7470-72) / 10 mL in 1 CUP, UNIT-DOSE (0904-7470-66)Marketed from Jun 26, 2024
0904-7470-950090474709550 CUP, UNIT-DOSE in 1 CASE (0904-7470-95) / 10 mL in 1 CUP, UNIT-DOSE (0904-7470-66)Marketed from Jun 26, 2024

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)
Sucralfate
Generic name (nonproprietary)
sucralfate oral suspension
Active ingredients
Sucralfate — 1 g/10mL
Dosage form
Suspension
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 211884
Marketing start
Listing expires
Other FDA classes
Organometallic Compounds (Chemical structure)
Identifiers
Product ID 0904-7470_886b2313-1f47-42e6-b0c9-e19e70b59492SPL ID 886b2313-1f47-42e6-b0c9-e19e70b59492SPL set ID 98a8fedd-fa06-416a-8a85-b899631978f9RxCUI 313123UNII XX73205DH5UPC 0309047470662
Pharmacologic class
Aluminum Complex

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

N400904747001 followed by a unit qualifier and the quantity

Package 00904-7470-01. 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 Sucralfate Oral Suspension is indicated in the short-term (up to 8weeks) treatment of active duodenal ulcer.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 211884

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

FDA NDC Directory listings under ANDA 211884
ProductStrengthForm · routeLabelerProduct NDC
SucralfateSucralfate 1 g/10mLSuspensionOralPAI Holdings, LLC dba PAI Pharma0121-0974
SucralfateSucralfate 1 g/10mLSuspensionOralAmerican Health Packaging60687-738
SucralfateSucralfate 1 g/10mLSuspensionOralCardinal Health 107, LLC55154-5790
SucralfateSucralfate 1 g/10mLSuspensionOralATLANTIC BIOLOGICALS CORP.17856-0306
SucralfateSucralfate 1 g/10mLSuspensionOralVistaPharm, LLC66689-305

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