NDC codes

FDA NDC Directory
Product NDC (as listed)10542-010Labeler and product segments. Claims need a package NDC.
Product NDC at billing width10542-0010Add 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
10542-010-0210542001002105420010027 TABLET, COATED in 1 BOTTLE, PLASTIC (10542-010-02)Marketed from Aug 1, 1988 · Sample package
10542-010-101054200101010542001010100 TABLET, COATED in 1 BOTTLE, PLASTIC (10542-010-10)Marketed from Aug 1, 1988

How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 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)
Dialyvite
Generic name (nonproprietary)
ascorbic acid, thiamine, riboflavin, niacinamide, pyridoxine, folic acid, cobalamin, biotin, pantothenic acid
Active ingredients
Ascorbic acid — 100 mg/1Thiamine mononitrate — 1.5 mg/1Riboflavin — 1.7 mg/1Niacinamide — 20 mg/1Pyridoxine hydrochloride — 10 mg/1Folic acid — 1 mg/1Cobalamin — 6 ug/1Biotin — 300 ug/1Calcium pantothenate — 10 mg/1
Dosage form
Tablet, Coated
Route
Oral
Labeler
Hillestad Pharmaceuticals USANDC labeler code 10542
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Marketing end
Other FDA classes
Analogs/Derivatives (Chemical/Ingredient)Ascorbic Acid (Chemical structure)Vitamin B 6 (Chemical/Ingredient)
Identifiers
Product ID 10542-010_c91498fd-0515-46a9-8a22-e423f554bd86SPL ID c91498fd-0515-46a9-8a22-e423f554bd86SPL set ID 7a5e6dd6-5687-44bb-8964-841961c0e64aUNII PQ6CK8PD0R, 8K0I04919X, TLM2976OFR, 25X51I8RD4, 68Y4CF58BV, 935E97BOY8, 8406EY2OQA, 6SO6U10H04, 568ET80C3DUPC 0105420101006
Pharmacologic class
Vitamin B6 Analog; Vitamin C

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

N410542001002 followed by a unit qualifier and the quantity

Package 10542-0010-02. 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 Dialyvite is a prescription folic acid supplement with additional nutrients indicated for use in improving the nutritional status of renal dialysis patients.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 10542-010

What is NDC 10542-010?
10542-010 is the product NDC for Dialyvite, Ascorbic acid 100 mg/1 + 8 more ingredients tablet, coated, listed with the FDA by Hillestad Pharmaceuticals USA. It has 2 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Dialyvite (Ascorbic Acid, Thiamine, Riboflavin, Niacinamide, Pyridoxine, Folic Acid, Cobalamin, Biotin, Pantothenic Acid).
What is the active ingredient?
Ascorbic acid, Thiamine mononitrate, Riboflavin, Niacinamide, Pyridoxine hydrochloride, Folic acid, Cobalamin, Biotin, Calcium pantothenate.
Who is the labeler?
Hillestad Pharmaceuticals USA, NDC labeler code 10542. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Dialyvite?
None: this is the only finished product listed under this name.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

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