GRASS MIX Number 4-S NDC 0268-8026

NDC codes

FDA NDC Directory

Product NDC (as listed)0268-8026Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00268-8026Add 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
0268-8026-06	00268802606	5.5 mL in 1 VIAL (0268-8026-06)Marketed from Dec 18, 1997

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): GRASS MIX Number 4-S
Generic name (nonproprietary): agrostis gigantea pollen, dactylis glomerata pollen, phleum pratense pollen and poa pratensis pollen
Active ingredients: Poa pratensis pollen — 25000 [BAU]/mLAgrostis gigantea pollen — 25000 [BAU]/mLDactylis glomerata pollen — 25000 [BAU]/mLPhleum pratense pollen — 25000 [BAU]/mL
Dosage form: Injection, Solution
Route: Percutaneous
Labeler: ALK-Abello, Inc.
Product type: Standardized allergenic
Marketing category: BLA — Biologics License ApplicationApplication BLA 103058
Marketing start: Dec 18, 1997
Listing expires: Dec 31, 2026
Other FDA classes: Allergens (Chemical structure)Allergens (Chemical structure)Allergens (Chemical structure)Allergens (Chemical structure)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased IgG Production (Physiologic effect)Increased IgG Production (Physiologic effect)Increased IgG Production (Physiologic effect)Increased IgG Production (Physiologic effect)Pollen (Chemical structure)Pollen (Chemical structure)Pollen (Chemical structure)Pollen (Chemical structure)
Identifiers: Product ID 0268-8026_f4170117-0559-46bb-a4fb-66138c6a9874SPL ID f4170117-0559-46bb-a4fb-66138c6a9874
Pharmacologic class: Non-Standardized Pollen Allergenic Extract; Standardized Pollen Allergenic Extract

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.

NDC on a medical claim

N400268802606 followed by a unit qualifier and the quantity

Package 00268-8026-06. 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

The FDA listing for this product does not reference a label (SPL) set.

Other NDCs under BLA 103058

Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.

FDA NDC Directory listings under BLA 103058
Product	Strength	Form · route	Labeler	Product NDC
Mix Of 5 Standardized Grass Pollenagrostis gigantea pollen, anthoxanthum odoratum pollen, dactylis glomerata pollen, phleum pratense pollen and poa pratensis pollen	Phleum pratense pollen 20000 [BAU]/mL + 4 more ingredients	Injection, SolutionSubcutaneous	ALK-Abello, Inc.	0268-8073
Mix Of 6 Standardized Grass Pollenagrostis gigantea pollen, dactylis glomerata pollen, festuca pratensis, lolium perenne pollen, phleum pratense pollen and poa pratensis pollen	Phleum pratense pollen 16667 [BAU]/mL + 5 more ingredients	Injection, SolutionSubcutaneous	ALK-Abello, Inc.	0268-8074
GRASS MIX Number 4-Sagrostis gigantea pollen, dactylis glomerata pollen, phleum pratense pollen and poa pratensis pollen	Poa pratensis pollen 25000 [BAU]/mL + 3 more ingredients	Injection, SolutionSubcutaneous	ALK-Abello, Inc.	0268-8027
Mix Of 7 Standardized Grass Pollenagrostis gigantea pollen, dactylis glomerata pollen, festuca pratensis, lolium perenne pollen, phleum pratense pollen, poa pratensis pollen and anthoxanthum odoratum pollen	Phleum pratense pollen 14286 [BAU]/mL + 6 more ingredients	Injection, SolutionSubcutaneous	ALK-Abello, Inc.	0268-8076
Midwest Mix Of Standardized Grassagrostis gigantea pollen, dactylis glomerata pollen, phleum pratense pollen and poa pratensis pollen	Phleum pratense pollen 40000 [BAU]/mL + 3 more ingredients	Injection, SolutionSubcutaneous	ALK-Abello, Inc.	0268-8077
Timothy, Standardized	Phleum pratense pollen 100000 [BAU]/mL	SolutionPercutaneous	ALK-Abello, Inc.	0268-3063
Timothy, Standardized	Phleum pratense pollen 100000 [BAU]/mL	Injection, SolutionSubcutaneous	ALK-Abello, Inc.	0268-0279