NDC codes

FDA NDC Directory
Product NDC (as listed)0781-4103Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00781-4103Add 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
0781-4103-15007814103153 BLISTER PACK in 1 PACKAGE (0781-4103-15) / 1 KIT in 1 BLISTER PACK (0781-4103-52)Marketed from Aug 1, 2015

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

Generic name (nonproprietary)
drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium
Dosage form
Kit
Labeler
Sandoz IncNDC labeler code 0781
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 022574
Marketing start
Listing expires
Identifiers
Product ID 0781-4103_6471e7a9-16b1-4b84-a113-fe6ac0ca5640SPL ID 6471e7a9-16b1-4b84-a113-fe6ac0ca5640SPL set ID 6928f186-190d-4c40-beab-81cf80cd45cbRxCUI 1013628, 1050492, 1050493

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

N400781410315 followed by a unit qualifier and the quantity

Package 00781-4103-15. 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 . This label includes a boxed warning.

Indications (excerpt from the label)

Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is a combination of drospirenone, a progestin and ethinyl estradiol, an estrogen containing a folate, indicated for use by females of reproductive potential to: • Prevent pregnancy. ( 1.1 ) • Raise folate levels in females of reproductive potential who choose to use an oral contraceptive for contraception. ( 1.2 ) 1.1 Oral Contraceptive Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is indicated for use by females of reproductive potential to prevent pregnancy. 1.2 Folate Supplementation Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium is indicated in females…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 0781-4103

What is NDC 0781-4103?
0781-4103 is the product NDC for Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium kit, listed with the FDA by Sandoz Inc. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium.
Who is the labeler?
Sandoz Inc, NDC labeler code 0781. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium?
1 other product NDC are listed under this name. See all Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium NDCs.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Drospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Drospirenone/Ethinyl Estradiol/Levomefolate Calcium and Levomefolate Calcium—KitSandoz Inc0781-407500781-4075-15

Other NDCs under NDA 022574

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

FDA NDC Directory listings under NDA 022574
ProductStrengthForm · routeLabelerProduct NDC
Safyraldrospirenone/ethinyl estradiol/levomefolate calcium and levomefolate calcium—KitBayer HealthCare Pharmaceuticals Inc.50419-403

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