NDC codes

FDA NDC Directory
Product NDC (as listed)58264-0078Labeler and product segments. Claims need a package NDC.
Product NDC at billing width58264-0078Add 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
58264-0078-15826400780129.57 mL in 1 BOTTLE, GLASS (58264-0078-1)Marketed from Jan 1, 1990

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)
D-77
Generic name (nonproprietary)
ammonium carbonate, apis mellifera, arsenic trioxide, grindelia hirsutula flowering top, echinacea angustifolia, and crotalus horridus horridus venom
Active ingredients
Ammonium carbonate — 12 [hp_X]/mLApis mellifera — 30 [hp_X]/mLArsenic trioxide — 30 [hp_X]/mLGrindelia hirsutula flowering top — 30 [hp_X]/mLEchinacea angustifolia — 6 [hp_X]/mLCrotalus horridus horridus venom — 30 [hp_X]/mL
Dosage form
Solution
Route
Sublingual
Product type
Over-the-counter drug
Marketing category
Unapproved homeopathic
Marketing start
Listing expires
Other FDA classes
Allergens (Chemical structure)Bee Venoms (Chemical structure)Cell-mediated Immunity (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased IgG Production (Physiologic effect)
Identifiers
Product ID 58264-0078_2b9ec82d-e5fb-ae16-e063-6394a90a5559SPL ID 2b9ec82d-e5fb-ae16-e063-6394a90a5559SPL set ID 4b0445cc-2e58-4ad1-b698-75f279f50549UNII NJ5VT0FKLJ, 7S82P3R43Z, S7V92P67HO, IDB0NAZ6AI, VB06AV5US8, YHA2XLJ956
Pharmacologic class
Standardized Insect Venom Allergenic Extract

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. Sublingual products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N458264007801 followed by a unit qualifier and the quantity

Package 58264-0078-01. 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 Allergic reaction to insects' bites and Poison Oak.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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