Modafinil NDC 0904-6791

NDC codes

FDA NDC Directory

Product NDC (as listed)0904-6791Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00904-6791Add 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
0904-6791-04	00904679104	30 BLISTER PACK in 1 CARTON (0904-6791-04) / 1 TABLET in 1 BLISTER PACKMarketed from Feb 3, 2014

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): Modafinil
Generic name (nonproprietary): modafinil
Active ingredients: Modafinil — 100 mg/1
Dosage form: Tablet
Route: Oral
Labeler: Major Pharmaceuticals
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 077667
Marketing start: Feb 3, 2014
Listing expires: Dec 31, 2026
DEA schedule: CIV
Other FDA classes: Central Nervous System Stimulation (Physiologic effect)Increased Sympathetic Activity (Physiologic effect)
Identifiers: Product ID 0904-6791_9b081f9e-c042-4aa8-833a-0701015ab9a4SPL ID 9b081f9e-c042-4aa8-833a-0701015ab9a4SPL set ID 4a7ab52b-db31-4774-a06a-b11f2bb60662RxCUI 205324, 260218UNII R3UK8X3U3D
Pharmacologic class: Sympathomimetic-like Agent

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

N400904679104 followed by a unit qualifier and the quantity

Package 00904-6791-04. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.