Tri-Vite Drops with Fluoride NDC 63629-1141

NDC codes

FDA NDC Directory

Product NDC (as listed)63629-1141Labeler and product segments. Claims need a package NDC.

Product NDC at billing width63629-1141Add 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
63629-1141-1	63629114101	50 mL in 1 BOTTLE (63629-1141-1)Marketed from Oct 6, 2020

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): Tri-Vite Drops with Fluoride
Generic name (nonproprietary): ascorbic acid, sodium fluoride, vitamin a and vitamin d
Active ingredients: Vitamin a — 1500 [iU]/mLAscorbic acid — 35 mg/mLVitamin d — 400 [iU]/mLSodium fluoride — .5 mg/mL
Dosage form: Solution
Route: Oral
Labeler: Bryant Ranch Prepack
Product type: Prescription drug
Marketing category: Unapproved drug (other)
Marketing start: Jul 25, 2018
Listing expires: Dec 31, 2027
Other FDA classes: Ascorbic Acid (Chemical structure)Vitamin A (Chemical structure)
Identifiers: Product ID 63629-1141_5ad59217-87ba-4028-8971-f9e377fc679bSPL ID 5ad59217-87ba-4028-8971-f9e377fc679bSPL set ID fe9da1e9-9b36-4702-bec2-13187f0f6548RxCUI 1365984UNII 81G40H8B0T, PQ6CK8PD0R, 9VU1KI44GP, 8ZYQ1474W7
Pharmacologic class: Vitamin A; 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

N463629114101 followed by a unit qualifier and the quantity

Package 63629-1141-01. 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 Mar 18, 2026.

Indications (excerpt from the label)

INDICATIONS AND USAGE Supplementation of the diet with vitamins A, C and D. Tri-Vite Drops with Fluoride 0.5 mg also provides fluoride for caries prophylaxis. The American Academy of Pediatrics recommend that infants and young children 6 months to 3 years of age, in areas where the drinking water contains less than 0.3 ppm of fluoride, and children 3-6 years of age, in areas where the drinking water contains 0.3 through 0.6 ppm of fluoride, receive 0.5 mg of supplemental fluoride daily which is provided in a dose of 1 mL of Tri-Vite Drops with Fluoride 0.5 mg (See Dosage and Administration ). Tri-Vite Drops with Fluoride 0.5 mg supply significant amounts of vitamins A, C and D to supplement …

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)