NDC codes

FDA NDC Directory
Product NDC (as listed)0990-7904Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00990-7904Add 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
0990-7904-090099079040912 POUCH in 1 CASE (0990-7904-09) / 1 BAG in 1 POUCH / 1000 mL in 1 BAGMarketed from Feb 1, 2020

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)
dextrose monohydrate, sodium chloride, and potassium chloride
Active ingredients
Dextrose monohydrate — 50 g/1000mLSodium chloride — 4.5 g/1000mLPotassium chloride — 2.98 g/1000mL
Dosage form
Injection, Solution
Route
Intravenous
Labeler
ICU Medical Inc.NDC labeler code 0990
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 018362
Marketing start
Listing expires
Other FDA classes
Increased Large Intestinal Motility (Physiologic effect)Increased Large Intestinal Motility (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Osmotic Activity (Mechanism)Osmotic Activity (Mechanism)Potassium Compounds (Chemical structure)
Identifiers
Product ID 0990-7904_11a3a5e5-57e6-49b9-bed9-c4db277a38beSPL ID 11a3a5e5-57e6-49b9-bed9-c4db277a38beSPL set ID d8ee14e9-6733-4813-9f21-2b043a5f7188RxCUI 615099, 615100, 615107, 615111, 630796, 1863605, 1863607, 1863973UNII 660YQ98I10, LX22YL083G, 451W47IQ8X
Pharmacologic class
Osmotic Laxative; Potassium Salt

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.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N400990790409 followed by a unit qualifier and the quantity

Package 00990-7904-09. 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 .

Indications (excerpt from the label)

INDICATIONS AND USAGE These solutions are indicated in patients requiring parenteral administration of potassium chloride with minimal carbohydrate calories and sodium chloride.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 0990-7904

What is NDC 0990-7904?
0990-7904 is the product NDC for Potassium Chloride in Dextrose and Sodium Chloride, Dextrose monohydrate 50 g/1000mL + 2 more ingredients injection, solution, listed with the FDA by ICU Medical Inc.. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Potassium Chloride in Dextrose and Sodium Chloride (DEXTROSE MONOHYDRATE, SODIUM CHLORIDE, and POTASSIUM CHLORIDE).
What is the active ingredient?
Dextrose monohydrate, Sodium chloride, Potassium chloride.
Who is the labeler?
ICU Medical Inc., NDC labeler code 0990. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Potassium Chloride in Dextrose and Sodium Chloride?
29 other product NDCs are listed under this name. See all Potassium Chloride in Dextrose and Sodium Chloride 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 Potassium Chloride in Dextrose and Sodium Chloride NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-15165219-0151-75
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-15365219-0153-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-11865219-0118-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-11965219-0119-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-14265219-0142-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-14465219-0144-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-14665219-0146-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-14865219-0148-10
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 25 g/500mL + 2 more ingredientsInjection, SolutionIntravenousFresenius Kabi USA, LLC65219-15065219-0150-75
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousICU Medical Inc.0990-790100990-7901-09

All 30 Potassium Chloride in Dextrose and Sodium Chloride NDCs

Other NDCs under NDA 018362

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

FDA NDC Directory listings under NDA 018362
ProductStrengthForm · routeLabelerProduct NDC
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousICU Medical Inc.0990-7902
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousICU Medical Inc.0990-7903
Potassium Chloride in Dextrose and Sodium Chloridedextrose monohydrate, sodium chloride, and potassium chlorideDextrose monohydrate 50 g/1000mL + 2 more ingredientsInjection, SolutionIntravenousICU Medical Inc.0990-7993

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