NDC codes

FDA NDC Directory
Product NDC (as listed)15370-250Labeler and product segments. Claims need a package NDC.
Product NDC at billing width15370-0250Add 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
15370-250-301537002503030 CAPSULE, LIQUID FILLED in 1 BOTTLE, PLASTIC (15370-250-30)Marketed from Jun 1, 2015

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)
TriStart DHA
Generic name (nonproprietary)
ascorbic acid, cholecalciferol, .alpha.-tocopherol acetate, d-, thiamine hydrochloride, riboflavin, niacin, pyridoxine hydrochloride, levomefolate magnesium, folic acid, cyanocobalamin, iron pentacarbonyl, potassium iodide, magnesium oxide, doconexent, and icosapent
Active ingredients
Ascorbic acid — 55 mg/1Cholecalciferol — 1000 [iU]/1.alpha.-tocopherol acetate, D- — 15 [iU]/1Thiamine hydrochloride — 1.3 mg/1Riboflavin — 1.8 mg/1Niacin — 5 mg/1Pyridoxine hydrochloride — 35 mg/1Levomefolate magnesium — 600 ug/1Folic acid — 400 ug/1Cyanocobalamin — 14 ug/1Iron pentacarbonyl — 31 mg/1Potassium iodide — 200 ug/1Magnesium oxide — 30 mg/1Doconexent — 200 mg/1Icosapent — 15 mg/1
Dosage form
Capsule, Liquid filled
Route
Oral
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Other FDA classes
Analogs/Derivatives (Chemical/Ingredient)Ascorbic Acid (Chemical structure)Folic Acid (Chemical structure)Increased Large Intestinal Motility (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Small Intestine Fluid/Electrolyte Absorption (Physiologic effect)Magnesium Ion Exchange Activity (Mechanism)Nicotinic Acids (Chemical structure)Osmotic Activity (Mechanism)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)Vitamin B 12 (Chemical structure)Vitamin B 6 (Chemical/Ingredient)Vitamin D (Chemical structure)
Identifiers
Product ID 15370-250_4889480e-2d59-4dbd-a808-ea7fce24f922SPL ID 4889480e-2d59-4dbd-a808-ea7fce24f922SPL set ID 92ccf7d4-4527-49f0-b890-1a11b5a10086UNII PQ6CK8PD0R, 1C6V77QF41, A7E6112E4N, M572600E5P, TLM2976OFR, 2679MF687A, 68Y4CF58BV, 1VZZ62R081, 935E97BOY8, P6YC3EG204, 6WQ62TAQ6Z, 1C4QK22F9J, 3A3U0GI71G, ZAD9OKH9JC, AAN7QOV9EAUPC 0315370250307
Pharmacologic class
Calculi Dissolution Agent; Folate Analog; Nicotinic Acid; Osmotic Laxative; Vitamin B12; Vitamin B6 Analog; Vitamin C; Vitamin D

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

N415370025030 followed by a unit qualifier and the quantity

Package 15370-0250-30. 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 TriStart DHA™ is an orally administered multivitamin/multimineral fatty acid dietary supplement indicated to improve the nutritional status of women throughout pregnancy and in the postnatal period for both lactating and nonlactating mothers. TriStart DHA™ can also be beneficial in improving the nutritional status of women prior to conception. This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent disease.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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