NDC codes

FDA NDC Directory
Product NDC (as listed)52796-173Labeler and product segments. Claims need a package NDC.
Product NDC at billing width52796-0173Add 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
52796-173-12527960173125279601731212 BLISTER PACK in 1 CARTON (52796-173-12) / 1 TABLET, CHEWABLE in 1 BLISTER PACKMarketed from Sep 10, 2015
52796-173-90527960173905279601739090 TABLET, CHEWABLE in 1 BOTTLE (52796-173-90)Marketed from Sep 10, 2015

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)
Floriva
Generic name (nonproprietary)
vitamin a acetate, .beta.-carotene, ascorbic acid, cholecalciferol, .alpha.-tocopherol, thiamine, riboflavin, niacinamide, pyridoxine, levomefolate glucosamine, folic acid, cyanocobalamin, biotin, zinc gluconate, cupric oxide, and sodium fluoride
Active ingredients
Vitamin a acetate — 1000 [iU]/1Beta carotene — 1000 [iU]/1Ascorbic acid — 75 mg/1Cholecalciferol — 600 [iU]/1.alpha.-tocopherol — 20 [iU]/1Thiamine — 1.3 mg/1Riboflavin — 1.5 mg/1Niacinamide — 15 mg/1Pyridoxine — 1.8 mg/1Levomefolate glucosamine — 162 ug/1Folic acid — 100 ug/1Cyanocobalamin — 6 ug/1Biotin — 40 ug/1Zinc gluconate — 5 mg/1Cupric oxide — 1 mg/1Sodium fluoride — .25 mg/1
Dosage form
Tablet, Chewable
Route
Oral
Labeler
BonGeo Pharmaceuticals, Inc.NDC labeler code 52796
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Other FDA classes
Analogs/Derivatives (Chemical/Ingredient)Ascorbic Acid (Chemical structure)Decreased Copper Ion Absorption (Physiologic effect)Vitamin A (Chemical structure)Vitamin B 12 (Chemical structure)Vitamin B 6 (Chemical/Ingredient)Vitamin D (Chemical structure)
Identifiers
Product ID 52796-173_fc2600e1-f961-4c00-9810-5612e8dfaaffSPL ID fc2600e1-f961-4c00-9810-5612e8dfaaffSPL set ID 3d5fbe3a-a95b-4688-a96e-b34e6e1e868aUNII 3LE3D9D6OY, 01YAE03M7J, PQ6CK8PD0R, 1C6V77QF41, H4N855PNZ1, X66NSO3N35, TLM2976OFR, 25X51I8RD4, KV2JZ1BI6Z, Q65PL71Q1A, 935E97BOY8, P6YC3EG204, 6SO6U10H04, U6WSN5SQ1Z, V1XJQ704R4, 8ZYQ1474W7
Pharmacologic class
Copper Absorption Inhibitor; Vitamin A; Vitamin B12; Vitamin B6 Analog; Vitamin C; Vitamin D

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

N452796017312 followed by a unit qualifier and the quantity

Package 52796-0173-12. 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 .

Full label on DailyMed (opens in a new tab)

About NDC 52796-173

What is NDC 52796-173?
52796-173 is the product NDC for Floriva, Vitamin a acetate 1000 [iU]/1 + 15 more ingredients tablet, chewable, listed with the FDA by BonGeo Pharmaceuticals, Inc.. It has 2 package NDCs, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Floriva (VITAMIN A ACETATE, .BETA.-CAROTENE, ASCORBIC ACID, CHOLECALCIFEROL, .ALPHA.-TOCOPHEROL, THIAMINE, RIBOFLAVIN, NIACINAMIDE, PYRIDOXINE, LEVOMEFOLATE GLUCOSAMINE, FOLIC ACID, CYANOCOBALAMIN, BIOTIN, ZINC GLUCONATE, CUPRIC OXIDE, and SODIUM FLUORIDE).
What is the active ingredient?
Vitamin a acetate, Beta carotene, Ascorbic acid, Cholecalciferol, .alpha.-tocopherol, Thiamine, Riboflavin, Niacinamide, Pyridoxine, Levomefolate glucosamine, Folic acid, Cyanocobalamin, Biotin, Zinc gluconate, Cupric oxide, Sodium fluoride.
Who is the labeler?
BonGeo Pharmaceuticals, Inc., NDC labeler code 52796. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Floriva?
3 other product NDCs are listed under this name. See all Floriva 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 Floriva NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Florivacholecalciferol and sodium fluorideCholecalciferol 400 [iU]/mL; Sodium fluoride .25 mg/mLLiquidOralBonGeo Pharmaceuticals, Inc.52796-17252796-0172-50
Florivavitamin a acetate, .beta.-carotene, ascorbic acid, cholecalciferol, .alpha.-tocopherol, thiamine, riboflavin, niacinamide, pyridoxine, levomefolate glucosamine, folic acid, cyanocobalamin, biotin, zinc gluconate, cupric oxide, and sodium fluorideVitamin a acetate 1000 [iU]/1 + 15 more ingredientsTablet, ChewableOralBonGeo Pharmaceuticals, Inc.52796-17452796-0174-0152796-0174-90
Florivavitamin a acetate, .beta.-carotene, ascorbic acid, cholecalciferol, .alpha.-tocopherol, thiamine, riboflavin, niacinamide, pyridoxine, levomefolate glucosamine, folic acid, cyanocobalamin, biotin, zinc gluconate, cupric oxide, and sodium fluorideVitamin a acetate 1000 [iU]/1 + 15 more ingredientsTablet, ChewableOralBonGeo Pharmaceuticals, Inc.52796-17752796-0177-90

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