D-103 NDC 58264-0109

NDC codes

FDA NDC Directory

Product NDC (as listed)58264-0109Labeler and product segments. Claims need a package NDC.

Product NDC at billing width58264-0109Add 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
58264-0109-1	58264010901	29.57 mL in 1 BOTTLE, GLASS (58264-0109-1)Marketed from Jan 1, 1990

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): D-103
Generic name (nonproprietary): aluminum oxide, silver, gold, beryllium, cadmium, copper, calcium sulfide, mercuric sulfate, molybdenum, nickel, plantago major, platinum, lead, anemone pratensis, selenium, and tin
Active ingredients: Aluminum oxide — 30 [hp_X]/mLSilver — 30 [hp_X]/mLGold — 30 [hp_X]/mLBeryllium — 30 [hp_X]/mLCadmium — 30 [hp_X]/mLCopper — 30 [hp_X]/mLCalcium sulfide — 12 [hp_X]/mLMercuric sulfate — 30 [hp_X]/mLMolybdenum — 30 [hp_X]/mLNickel — 30 [hp_X]/mLPlantago major — 4 [hp_X]/mLPlatinum — 30 [hp_X]/mLLead — 30 [hp_X]/mLAnemone pratensis — 6 [hp_X]/mLSelenium — 30 [hp_X]/mLTin — 30 [hp_X]/mL
Dosage form: Solution
Route: Sublingual
Labeler: DNA Labs, Inc.
Product type: Over-the-counter drug
Marketing category: Unapproved homeopathic
Marketing start: Jan 1, 1990
Listing expires: Dec 31, 2026
Other FDA classes: Allergens (Chemical structure)Allergens (Chemical structure)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Copper (Chemical structure)Decreased Embryonic Implantation (Physiologic effect)Decreased Sperm Motility (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Inhibit Ovum Fertilization (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Osmotic Activity (Mechanism)
Identifiers: Product ID 58264-0109_2b9ecbda-710d-d64a-e063-6294a90aac9eSPL ID 2b9ecbda-710d-d64a-e063-6294a90aac9eSPL set ID f4efd03d-3f80-4694-9a02-b71b7e3e3f0dUNII LMI26O6933, 3M4G523W1G, 79Y1949PYO, OW5102UV6N, 00BH33GNGH, 789U1901C5, 1MBW07J51Q, J4L3PPG58I, 81AH48963U, 7OV03QG267, W2469WNO6U, 49DFR088MY, 2P299V784P, 8E272251DI, H6241UJ22B, 387GMG9FH5
Pharmacologic class: Copper-containing Intrauterine Device; Osmotic Laxative; Standardized Chemical Allergen

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. Sublingual products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N458264010901 followed by a unit qualifier and the quantity

Package 58264-0109-01. 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 Jan 13, 2025.

Indications (excerpt from the label)

INDICATIONS Antidote for environmental toxins.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)