Dianeal Low Calcium With Dextrose NDC 0941-0696

NDC codes

FDA NDC Directory

Product NDC (as listed)0941-0696Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00941-0696Add 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 NDC	11-digit (billing)	Package	Copy
0941-0696-06	00941069606	6 BAG in 1 CARTON (0941-0696-06) / 2000 mL in 1 BAG (0941-0696-01)Marketed from Oct 30, 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): Dianeal Low Calcium With Dextrose
Generic name (nonproprietary): sodium chloride, sodium lactate, calcium chloride, magnesium chloride and dextrose
Active ingredients: Dextrose monohydrate — 4.25 g/100mLSodium chloride — 538 mg/100mLSodium lactate — 448 mg/100mLCalcium chloride — 18.3 mg/100mLMagnesium chloride — 5.08 mg/100mL
Dosage form: Injection, Solution
Route: Intraperitoneal
Labeler: Vantive US Healthcare LLC
Product type: Prescription drug
Marketing category: Unapproved drug for use in drug shortage
Marketing start: Oct 30, 2024
Marketing end: Dec 31, 2026
Other FDA classes: Calcium (Chemical structure)Divalent (Chemical structure)Increased Coagulation Factor Activity (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Small Intestine Fluid/Electrolyte Absorption (Physiologic effect)Magnesium Ion Exchange Activity (Mechanism)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Phosphate Chelating Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers: Product ID 0941-0696_34a6a205-ce19-47ae-e063-6394a90acc12SPL ID 34a6a205-ce19-47ae-e063-6394a90acc12SPL set ID 50fc30a0-0eca-452e-825e-08c2647ccfc1RxCUI 800062, 800064, 800066, 800074UNII LX22YL083G, M4I0D6VV5M, TU7HW0W0QT, 02F3473H9O, 451W47IQ8X
Pharmacologic class: Blood Coagulation Factor; Calculi Dissolution Agent; Osmotic Laxative; Phosphate Binder

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.

NDC on a medical claim

N400941069606 followed by a unit qualifier and the quantity

Package 00941-0696-06. 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 May 8, 2025.

Full label on DailyMed (opens in a new tab)