Lisdexamfetamine Dimesylate NDC 0406-5126

NDC codes

FDA NDC Directory

Product NDC (as listed)0406-5126Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00406-5126Add 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
0406-5126-01	00406512601	100 TABLET, CHEWABLE in 1 BOTTLE (0406-5126-01)Marketed from Dec 17, 2024

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): Lisdexamfetamine Dimesylate
Generic name (nonproprietary): lisdexamfetamine dimesylate
Active ingredients: Lisdexamfetamine dimesylate — 30 mg/1
Dosage form: Tablet, Chewable
Route: Oral
Labeler: SpecGx LLC
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 218850
Marketing start: Dec 17, 2024
Listing expires: Dec 31, 2026
DEA schedule: CII
Other FDA classes: Central Nervous System Stimulation (Physiologic effect)
Identifiers: Product ID 0406-5126_02215a03-fa4d-4785-9d38-4f22d92faf31SPL ID 02215a03-fa4d-4785-9d38-4f22d92faf31SPL set ID 3a79b2ab-4131-4978-99a0-0119df57d5feRxCUI 1871456, 1871460, 1871462, 1871464, 1871466, 1871468UNII SJT761GEGSUPC 0304065125013, 0304065128014, 0304065126010, 0304065127017, 0304065129011, 0304065124016
Pharmacologic class: Central Nervous System Stimulant

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

N400406512601 followed by a unit qualifier and the quantity

Package 00406-5126-01. 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

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