Multivitamin with Fluoride NDC 58657-165

NDC codes

FDA NDC Directory

Product NDC (as listed)58657-165Labeler and product segments. Claims need a package NDC.

Product NDC at billing width58657-0165Add 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
58657-165-01	58657016501	100 TABLET, CHEWABLE in 1 BOTTLE (58657-165-01)Marketed from Jul 20, 2018
58657-165-90	58657016590	90 TABLET, CHEWABLE in 1 BOTTLE (58657-165-90)Marketed from Jul 20, 2018

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): Multivitamin with Fluoride
Generic name (nonproprietary): .alpha.-tocopherol acetate, dl-, ascorbic acid, cyanocobalamin, folic acid, niacin, pyridoxine, riboflavin, sodium fluoride, thiamine mononitrate, vitamin a and vitamin d
Active ingredients: Vitamin a — 2500 [iU]/1Ascorbic acid — 60 mg/1Vitamin d — 400 [iU]/1.alpha.-tocopherol acetate, Dl- — 15 [iU]/1Thiamine mononitrate — 1.05 mg/1Riboflavin — 1.2 mg/1Niacin — 13.5 mg/1Pyridoxine — 1.05 mg/1Folic acid — 300 ug/1Cyanocobalamin — 4.5 ug/1Sodium fluoride — 1 mg/1
Dosage form: Tablet, Chewable
Route: Oral
Labeler: Method Pharmaceuticals, LLC
Product type: Prescription drug
Marketing category: Unapproved drug (other)
Marketing start: Jul 20, 2018
Listing expires: Dec 31, 2026
Other FDA classes: Analogs/Derivatives (Chemical/Ingredient)Ascorbic Acid (Chemical structure)Nicotinic Acids (Chemical structure)Vitamin A (Chemical structure)Vitamin B 12 (Chemical structure)Vitamin B 6 (Chemical/Ingredient)
Identifiers: Product ID 58657-165_41b614ba-11eb-895a-e063-6294a90a8ae3SPL ID 41b614ba-11eb-895a-e063-6294a90a8ae3SPL set ID 71698332-4ab1-4cbb-a98d-1694b715924bRxCUI 1364855UNII 81G40H8B0T, PQ6CK8PD0R, 9VU1KI44GP, WR1WPI7EW8, 8K0I04919X, TLM2976OFR, 2679MF687A, KV2JZ1BI6Z, 935E97BOY8, P6YC3EG204, 8ZYQ1474W7UPC 0358657165901, 0358657165017
Pharmacologic class: Nicotinic Acid; Vitamin A; Vitamin B12; Vitamin B6 Analog; Vitamin C

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

N458657016501 followed by a unit qualifier and the quantity

Package 58657-0165-01. 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 Oct 21, 2025.

Indications (excerpt from the label)

INDICATIONS AND USAGE Supplementation of the diet with ten essential vitamins. Supplementation of the diet with fluoride for caries prophylaxis. Multivitamin with Fluoride 1.0 mg Chewable Tablets provide 1.0 mg fluoride in tablet form for children 6-16 years of age in areas where the water fluoride level is less than 0.3 ppm. Multivitamin with Fluoride 1.0 mg Chewable Tablets supply significant amounts of Vitamins A, C, D, E, thiamine, riboflavin, niacin, vitamin B6, vitamin B12, and folate to supplement the diet, and to help assure that nutritional deficiencies of these vitamins will not develop. Thus, in a single easy-to-use preparation, children obtain ten essential vitamins and the impor…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)