NDC codes

FDA NDC Directory
Product NDC (as listed)0904-6938Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00904-6938Add 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
0904-6938-060090469380650 BLISTER PACK in 1 CARTON (0904-6938-06) / 1 TABLET in 1 BLISTER PACKMarketed from Sep 13, 2012

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)
Butalbital, Acetaminophen, and Caffeine
Generic name (nonproprietary)
butalbital, acetaminophen, and caffeine
Active ingredients
Butalbital — 50 mg/1Acetaminophen — 325 mg/1Caffeine — 40 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 200243
Marketing start
Listing expires
DEA schedule
CIII
Other FDA classes
Barbiturates (Chemical structure)Central Nervous System Stimulation (Physiologic effect)Xanthines (Chemical structure)
Identifiers
Product ID 0904-6938_32566e32-634f-4d28-b269-a65e97a1d258SPL ID 32566e32-634f-4d28-b269-a65e97a1d258SPL set ID 0ca49c3c-f2cb-40e3-a7d5-5f48eca59016RxCUI 238154UNII KHS0AZ4JVK, 362O9ITL9D, 3G6A5W338E
Pharmacologic class
Barbiturate; Central Nervous System Stimulant; Methylxanthine

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

N400904693806 followed by a unit qualifier and the quantity

Package 00904-6938-06. 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

Current FDA label (SPL), effective . This label includes a boxed warning.

Indications (excerpt from the label)

INDICATIONS AND USAGE Butalbital, acetaminophen, and caffeine tablets, USP are indicated for the relief of the symptom complex of tension (or muscle contraction) headache. Evidence supporting the efficacy and safety of this combination product in the treatment of multiple recurrent headaches is unavailable. Caution in this regard is required because butalbital is habit-forming and potentially abusable.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 200243

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

FDA NDC Directory listings under ANDA 200243
ProductStrengthForm · routeLabelerProduct NDC
Butalbital, Acetaminophen, and CaffeineButalbital 50 mg/1 + 2 more ingredientsTabletOralProficient Rx LP63187-933
Butalbital, Acetaminophen, and CaffeineButalbital 50 mg/1 + 2 more ingredientsTabletOralCardinal Health 107, LLC55154-3356
Butalbital, Acetaminophen, and CaffeineButalbital 50 mg/1 + 2 more ingredientsTabletOralBryant Ranch Prepack63629-8392
Butal/APAP/CaffButalbital 50 mg/1 + 2 more ingredientsTabletOralDirect_Rx72189-441
Butalbital, Acetaminophen, and CaffeineAcetaminophen 325 mg/1 + 2 more ingredientsTabletOralNuCare Pharmaceuticals, Inc.68071-3249
Butalbital, Acetaminophen, and CaffeineButalbital 50 mg/1 + 2 more ingredientsTabletOralLannett Company, Inc.0527-1695
Butalbital, Acetaminophen, and CaffeineButalbital 50 mg/1 + 2 more ingredientsTabletOralREMEDYREPACK INC.70518-1134

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