NDC codes

FDA NDC Directory
Product NDC (as listed)0264-7703Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00264-7703Add 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
0264-7703-000026477030012 CONTAINER in 1 CASE (0264-7703-00) / 1000 mL in 1 CONTAINERMarketed from Sep 29, 1989

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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)
Isolyte S
Generic name (nonproprietary)
sodium chloride, sodium gluconate, sodium acetate, potassium chloride, and magnesium chloride
Active ingredients
Sodium chloride — .53 g/100mLSodium gluconate — .5 g/100mLSodium acetate — .37 g/100mLPotassium chloride — .037 g/100mLMagnesium chloride — .03 g/100mL
Dosage form
Injection, Solution
Route
Intravenous
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 019711
Marketing start
Listing expires
Other FDA classes
Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Small Intestine Fluid/Electrolyte Absorption (Physiologic effect)Magnesium Ion Exchange Activity (Mechanism)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Potassium Compounds (Chemical structure)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers
Product ID 0264-7703_e9350a07-ea60-46e4-9ed5-81cc371f9696SPL ID e9350a07-ea60-46e4-9ed5-81cc371f9696SPL set ID 7e8fe27f-ff82-48c1-9bf6-3c589c8e985dRxCUI 800925, 800928UNII 451W47IQ8X, R6Q3791S76, 4550K0SC9B, 660YQ98I10, 02F3473H9O
Pharmacologic class
Calculi Dissolution Agent; Osmotic Laxative; Potassium Salt

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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N400264770300 followed by a unit qualifier and the quantity

Package 00264-7703-00. 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 .

Indications (excerpt from the label)

INDICATIONS AND USAGE This solution is indicated for use in adults and pediatric patients as a source of electrolytes and water for hydration, and as an alkalinizing agent.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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