D-114 NDC 58264-0120

NDC codes

FDA NDC Directory

Product NDC (as listed)58264-0120Labeler and product segments. Claims need a package NDC.

Product NDC at billing width58264-0120Add 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
58264-0120-1	58264012001	29.57 mL in 1 BOTTLE, GLASS (58264-0120-1)Marketed from Mar 15, 2023

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-114
Generic name (nonproprietary): aluminum metallicum, ailanthus, baptisia tinctoria, fragaria vesca, yoscyamus niger, muriaticum acid
Active ingredients: Aluminum — 30 [hp_X]/mLAilanthus altissima flowering twig — 30 [hp_X]/mLHyoscyamus niger — 30 [hp_X]/mLHydrochloric acid — 12 [hp_X]/mLBaptisia tinctoria root — 30 [hp_X]/mLFragaria vesca fruit — 30 [hp_X]/mL
Dosage form: Solution
Route: Sublingual
Labeler: DNA Labs
Product type: Over-the-counter drug
Marketing category: Unapproved homeopathic
Marketing start: Mar 15, 2023
Listing expires: Dec 31, 2026
Identifiers: Product ID 58264-0120_2b9eda10-4e9e-e31e-e063-6394a90a53c6SPL ID 2b9eda10-4e9e-e31e-e063-6394a90a53c6SPL set ID f6f7d369-64ef-0ed9-e053-6294a90a40faUNII CPD4NFA903, 8P29O5P7XU, 4WRK2153H3, QTT17582CB, 5EF0HWI5WU, CG6IX3GCMU

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

N458264012001 followed by a unit qualifier and the quantity

Package 58264-0120-01. 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)

Debris crusts accumulated on teeth, tartar.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)