Vaccine · BLA
Pediarix NDC 50090-7541
Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated) 25 [iU]/.5mL + 8 more ingredients · Injection, Suspension · Intramuscular · A-S Medication Solutions
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 50090-7541-0 | 5009075410050090754100 | 10 SYRINGE in 1 CARTON (50090-7541-0) / .5 mL in 1 SYRINGE (50090-7541-1)Marketed from Jul 24, 2009 |
How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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)
- Pediarix
- Generic name (nonproprietary)
- diphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis b (recombinant) and inactivated poliovirus vaccine combined
- Active ingredients
- Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated) — 25 [iU]/.5mLClostridium tetani toxoid antigen (Formaldehyde inactivated) — 10 [iU]/.5mLBordetella pertussis toxoid antigen (Formaldehyde, Glutaraldehyde inactivated) — 25 ug/.5mLBordetella pertussis filamentous hemagglutinin antigen (Formaldehyde inactivated) — 25 ug/.5mLBordetella pertussis pertactin antigen (Formaldehyde inactivated) — 8 ug/.5mLHepatitis b virus subtype adw2 hbsag surface protein antigen — 10 ug/.5mLPoliovirus type 1 antigen (Formaldehyde inactivated) — 40 [iU]/.5mLPoliovirus type 2 antigen (Formaldehyde inactivated) — 8 [iU]/.5mLPoliovirus type 3 antigen (Formaldehyde inactivated) — 32 [iU]/.5mL
- Dosage form
- Injection, Suspension
- Route
- Intramuscular
- Labeler
- A-S Medication SolutionsNDC labeler code 50090
- Product type
- Vaccine
- Marketing category
- BLA — Biologics License ApplicationApplication BLA 103907
- Marketing start
- Listing expires
- Other FDA classes
- Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Actively Acquired Immunity (Physiologic effect)Diphtheria Toxoid (Chemical structure)Pertussis Vaccine (Chemical structure)Pertussis Vaccine (Chemical structure)Pertussis Vaccine (Chemical structure)Poliovirus Vaccines (Chemical structure)Poliovirus Vaccines (Chemical structure)Poliovirus Vaccines (Chemical structure)Tetanus Toxoid (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)Inactivated (Chemical structure)
- Identifiers
- Product ID 50090-7541_479d4986-8756-4316-ba84-5ef27a8ec54bSPL ID 479d4986-8756-4316-ba84-5ef27a8ec54b
- Pharmacologic class
- Inactivated Bordetella Pertussis Vaccine; Inactivated Clostridium Tetani Vaccine; Inactivated Corynebacterium Diphtheriae Vaccine; Inactivated Poliovirus Vaccine
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
Immunization administration (CPT 90460–90474)
Giving a vaccine is reported separately from the vaccine product code, with an immunization administration code. Which code applies depends on the patient's age, the route and whether counselling was provided.
- NDC on a medical claim
N450090754100followed by a unit qualifier and the quantityPackage 50090-7541-00. 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
The FDA listing for this product does not reference a label (SPL) set.
About NDC 50090-7541
- What is NDC 50090-7541?
- 50090-7541 is the product NDC for Pediarix, Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated) 25 [iU]/.5mL + 8 more ingredients injection, suspension, listed with the FDA by A-S Medication Solutions. It has 1 package NDC, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- Pediarix (Diphtheria and Tetanus Toxoids and Acellular Pertussis Adsorbed, Hepatitis B (Recombinant) and Inactivated Poliovirus Vaccine Combined).
- What is the active ingredient?
- Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated), Clostridium tetani toxoid antigen (Formaldehyde inactivated), Bordetella pertussis toxoid antigen (Formaldehyde, Glutaraldehyde inactivated), Bordetella pertussis filamentous hemagglutinin antigen (Formaldehyde inactivated), Bordetella pertussis pertactin antigen (Formaldehyde inactivated), Hepatitis b virus subtype adw2 hbsag surface protein antigen, Poliovirus type 1 antigen (Formaldehyde inactivated), Poliovirus type 2 antigen (Formaldehyde inactivated), Poliovirus type 3 antigen (Formaldehyde inactivated).
- Who is the labeler?
- A-S Medication Solutions, NDC labeler code 50090. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for Pediarix?
- 1 other product NDC are listed under this name. See all Pediarix NDCs.
- Is there a related HCPCS / J-code?
- Not in Med-Code's curated HCPCS directory. See Billing references above.
Related NDCs: other Pediarix products
Other finished products listed under the same name: strengths, forms and labelers.
| Product | Strength | Form · route | Labeler | Product NDC | Package NDCs (11-digit) |
|---|---|---|---|---|---|
| Pediarixdiphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis b (recombinant) and inactivated poliovirus vaccine combined | Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated) 25 [iU]/.5mL + 8 more ingredients | Injection, SuspensionIntramuscular | GlaxoSmithKline Biologicals SA | 58160-811 | 58160-0811-52 |
Other NDCs under BLA 103907
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
| Product | Strength | Form · route | Labeler | Product NDC |
|---|---|---|---|---|
| Pediarixdiphtheria and tetanus toxoids and acellular pertussis adsorbed, hepatitis b (recombinant) and inactivated poliovirus vaccine combined | Corynebacterium diphtheriae toxoid antigen (Formaldehyde inactivated) 25 [iU]/.5mL + 8 more ingredients | Injection, SuspensionIntramuscular | GlaxoSmithKline Biologicals SA | 58160-811 |