NDC codes

FDA NDC Directory
Product NDC (as listed)54288-159Labeler and product segments. Claims need a package NDC.
Product NDC at billing width54288-0159Add 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
54288-159-05542880159055 SYRINGE in 1 PACKAGE (54288-159-05) / 2 mL in 1 SYRINGE (54288-159-01)Marketed from May 15, 2023

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)
Methylene Blue
Generic name (nonproprietary)
methylene blue
Active ingredients
Methylene blue — 10 mg/mL
Dosage form
Injection
Route
Intravenous
Product type
Prescription drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Other FDA classes
Oxidation-Reduction Activity (Mechanism)
Identifiers
Product ID 54288-159_e36054e3-076c-46d7-82f1-33b3d9481376SPL ID e36054e3-076c-46d7-82f1-33b3d9481376SPL set ID fbdd583d-45ba-4d42-8c80-9a13b71980b6RxCUI 2637038UNII T42P99266KUPC 0354288159050, 0354288159012
Pharmacologic class
Oxidation-Reduction Agent

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

N454288015905 followed by a unit qualifier and the quantity

Package 54288-0159-05. 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 AND USAGE : Drug-induced methemoglobinemia

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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