What is NDC 50090-1377?

50090-1377 is the product NDC for Boostrix, Clostridium tetani toxoid antigen (Formaldehyde inactivated) 5 [iU]/.5mL + 4 more ingredients suspension, listed with the FDA by A-S Medication Solutions. It has 2 package NDCs, shown above in 10- and 11-digit form.

What drug is associated with this NDC?

Boostrix (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed).

What is the active ingredient?

Clostridium tetani toxoid antigen (Formaldehyde inactivated), Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated), Bordetella pertussis toxoid antigen (Formaldehyde, Glutaraldehyde inactivated), Bordetella pertussis filamentous hemagglutinin antigen (Formaldehyde inactivated), Bordetella pertussis pertactin antigen (Formaldehyde inactivated).

A-S Medication Solutions, NDC labeler code 50090. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.

What other NDCs exist for Boostrix?

1 other product NDC are listed under this name.

Is there a related HCPCS / J-code?

Not in Med-Code's curated HCPCS directory.

Boostrix NDC 50090-1377 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)50090-1377Labeler and product segments. Claims need a package NDC.

Product NDC at billing width50090-1377Add 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
50090-1377-0	5009013770050090137700	10 SYRINGE in 1 CARTON (50090-1377-0) / .5 mL in 1 SYRINGE (50090-1377-2)Marketed from Jul 24, 2009
50090-1377-1	5009013770150090137701	1 SYRINGE in 1 POUCH (50090-1377-1) / .5 mL in 1 SYRINGEMarketed from Jul 24, 2009

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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): Boostrix
Generic name (nonproprietary): tetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed
Active ingredients: Clostridium tetani toxoid antigen (Formaldehyde inactivated) — 5 [iU]/.5mLCorynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated) — 2.5 [iU]/.5mLBordetella pertussis toxoid antigen (Formaldehyde, Glutaraldehyde inactivated) — 8 ug/.5mLBordetella pertussis filamentous hemagglutinin antigen (Formaldehyde inactivated) — 8 ug/.5mLBordetella pertussis pertactin antigen (Formaldehyde inactivated) — 2.5 ug/.5mL
Dosage form: Suspension
Route: Intramuscular
Labeler: A-S Medication SolutionsNDC labeler code 50090
Product type: Vaccine
Marketing category: BLA — Biologics License ApplicationApplication BLA 125106
Marketing start: Jul 24, 2009
Listing expires: Dec 31, 2026
Other FDA classes: Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Diphtheria Toxoid (Chemical structure)Pertussis Vaccine (Chemical structure)Pertussis Vaccine (Chemical structure)Pertussis Vaccine (Chemical structure)Tetanus Toxoid (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)
Identifiers: Product ID 50090-1377_2e2b4c6a-d397-41b8-babf-adc104e8fbefSPL ID 2e2b4c6a-d397-41b8-babf-adc104e8fbef
Pharmacologic class: Inactivated Bordetella Pertussis Vaccine; Inactivated Clostridium Tetani Vaccine; Inactivated Corynebacterium Diphtheriae Vaccine

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

Immunization administration (CPT 90460–90474)

Giving a vaccine is reported separately from the vaccine product code, with an immunization administration code. Which code applies depends on the patient's age, the route and whether counselling was provided.

How CPT relates to drug billing

NDC on a medical claim

N450090137700 followed by a unit qualifier and the quantity

Package 50090-1377-00. 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

The FDA listing for this product does not reference a label (SPL) set.

About NDC 50090-1377

What is NDC 50090-1377?: 50090-1377 is the product NDC for Boostrix, Clostridium tetani toxoid antigen (Formaldehyde inactivated) 5 [iU]/.5mL + 4 more ingredients suspension, listed with the FDA by A-S Medication Solutions. It has 2 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Boostrix (Tetanus Toxoid, Reduced Diphtheria Toxoid and Acellular Pertussis Vaccine, Adsorbed).
What is the active ingredient?: Clostridium tetani toxoid antigen (Formaldehyde inactivated), Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated), Bordetella pertussis toxoid antigen (Formaldehyde, Glutaraldehyde inactivated), Bordetella pertussis filamentous hemagglutinin antigen (Formaldehyde inactivated), Bordetella pertussis pertactin antigen (Formaldehyde inactivated).
Who is the labeler?: A-S Medication Solutions, NDC labeler code 50090. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Boostrix?: 1 other product NDC are listed under this name. See all Boostrix NDCs.
Is there a related HCPCS / J-code?: Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Boostrix NDCs
Product	Strength	Form · route	Labeler	Product NDC	Package NDCs (11-digit)
Boostrixtetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed	Clostridium tetani toxoid antigen (Formaldehyde inactivated) 5 [iU]/.5mL + 4 more ingredients	SuspensionIntramuscular	GlaxoSmithKline Biologicals SA	58160-842	58160-0842-52

Other NDCs under BLA 125106

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

FDA NDC Directory listings under BLA 125106
Product	Strength	Form · route	Labeler	Product NDC
Boostrixtetanus toxoid, reduced diphtheria toxoid and acellular pertussis vaccine, adsorbed	Clostridium tetani toxoid antigen (Formaldehyde inactivated) 5 [iU]/.5mL + 4 more ingredients	SuspensionIntramuscular	GlaxoSmithKline Biologicals SA	58160-842