NDC codes

FDA NDC Directory
Product NDC (as listed)13411-868Labeler and product segments. Claims need a package NDC.
Product NDC at billing width13411-0868Add 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
13411-868-151341108681515 POWDER in 1 PACKET (13411-868-15)Marketed from Nov 8, 2024
13411-868-301341108683030 POWDER in 1 PACKET (13411-868-30)Marketed from Nov 8, 2024

How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 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)
Jba Ativ Electrolyte Ors Lavender Lemonade
Generic name (nonproprietary)
potassium,magnesium,zinc
Active ingredients
Potassium — 190 mg/1Magnesium — 50 mg/1Zinc — 10 mg/1
Dosage form
Powder
Route
Oral
Product type
Over-the-counter drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Identifiers
Product ID 13411-868_44a85cf4-2d9e-16cb-e063-6394a90a12e6SPL ID 44a85cf4-2d9e-16cb-e063-6394a90a12e6SPL set ID 6356c6c3-4c7e-4d4b-aecb-60b92ebf5f1eUNII RWP5GA015D, I38ZP9992A, J41CSQ7QDS

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

N413411086815 followed by a unit qualifier and the quantity

Package 13411-0868-15. 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 .

Full label on DailyMed (opens in a new tab)

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