NDC codes

FDA NDC Directory
Product NDC (as listed)50633-220Labeler and product segments. Claims need a package NDC.
Product NDC at billing width50633-0220Add 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
50633-220-0450633022004506330220044 PACKET in 1 CARTON (50633-220-04) / 10 g in 1 PACKET (50633-220-10)Marketed from Jul 31, 2024
50633-220-20506330220205063302202020 PACKET in 1 CARTON (50633-220-20) / 10 g in 1 PACKET (50633-220-10)Marketed from Jul 31, 2024

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)
Vistogard
Generic name (nonproprietary)
uridine triacetate
Active ingredients
Uridine triacetate — 951 mg/g
Dosage form
Granule
Route
Oral
Labeler
BTG International IncNDC labeler code 50633
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 208159
Marketing start
Listing expires
Other FDA classes
Analogs/Derivatives (Chemical/Ingredient)Pyrimidines (Chemical/Ingredient)
Identifiers
Product ID 50633-220_4e4e69bd-abb4-4632-e063-6394a90ab642SPL ID 4e4e69bd-abb4-4632-e063-6394a90ab642SPL set ID 269f7363-63ed-444e-85f1-f0009e44818bRxCUI 1739794, 1739800UNII 2WP61F175MUPC 0350633220109
Pharmacologic class
Pyrimidine Analog

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

N450633022004 followed by a unit qualifier and the quantity

Package 50633-0220-04. 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)

VISTOGARD ® is indicated for the emergency treatment of adult and pediatric patients: following a fluorouracil or capecitabine overdose regardless of the presence of symptoms, or who exhibit early-onset, severe or life-threatening toxicity affecting the cardiac or central nervous system, and/or early-onset, unusually severe adverse reactions (e.g., gastrointestinal toxicity and/or neutropenia) within 96 hours following the end of fluorouracil or capecitabine administration. VISTOGARD ® is a pyrimidine analog indicated for the emergency treatment of adult and pediatric patients: following a fluorouracil or capecitabine overdose regardless of the presence of symptoms, or who exhibit early-onse…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 50633-220

What is NDC 50633-220?
50633-220 is the product NDC for Vistogard (uridine triacetate), Uridine triacetate 951 mg/g granule, listed with the FDA by BTG International Inc. It has 2 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Vistogard (Uridine triacetate).
What is the active ingredient?
Uridine triacetate.
Who is the labeler?
BTG International Inc, NDC labeler code 50633. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Vistogard?
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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