NDC codes

FDA NDC Directory
Product NDC (as listed)0904-7523Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00904-7523Add 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
0904-7523-080090475230840 BLISTER PACK in 1 CARTON (0904-7523-08) / 1 CAPSULE in 1 BLISTER PACKMarketed from Oct 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)
Dofetilide
Generic name (nonproprietary)
dofetilide
Active ingredients
Dofetilide — .25 mg/1
Dosage form
Capsule
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 207058
Marketing start
Marketing end
Identifiers
Product ID 0904-7523_ee9fe799-9bd7-4caa-b629-0464d2417a68SPL ID ee9fe799-9bd7-4caa-b629-0464d2417a68SPL set ID 26de5f8c-8cec-46f6-a468-69451758a278RxCUI 310003, 310004, 310005UNII R4Z9X1N2ND
Pharmacologic class
Antiarrhythmic

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

N400904752308 followed by a unit qualifier and the quantity

Package 00904-7523-08. 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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