What is NDC 63083-1004?

63083-1004 is the product NDC for Dairy Mix 1004 (dairy mix), Sus scrofa adrenal gland 6 [hp_X]/59mL + 14 more ingredients liquid, listed with the FDA by Professional Complementary Health Formulas. It has 1 package NDC, shown above in 10- and 11-digit form.

What is the active ingredient?

Sus scrofa adrenal gland, Corticotropin, Histamine dihydrochloride, Beef liver, Casein, Lactococcus lactis cultured, Aged, Blue tilapia whole, Casein, Lactococcus lactis cultured, Penicillium camemberti cultured, Aged, Casein, Lactococcus lactis cultured, Cow milk fat, Casein, Streptococcus thermophilus cultured, Propionibacterium freudenreichii subsp. Shermanii cultured, Aged, Whey, Swiss chard, Cow milk, Goat milk, Human milk.

Professional Complementary Health Formulas, NDC labeler code 63083. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.

What other NDCs exist for Dairy Mix 1004?

None: this is the only finished product listed under this name.

Is there a related HCPCS / J-code?

Not in Med-Code's curated HCPCS directory.

Dairy Mix 1004 NDC 63083-1004 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)63083-1004Labeler and product segments. Claims need a package NDC.

Product NDC at billing width63083-1004Add 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 NDC	11-digit (billing)	Package	Copy
63083-1004-2	63083100402	59 mL in 1 BOTTLE, DROPPER (63083-1004-2)Marketed from Aug 15, 1985

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): Dairy Mix 1004Suffix: 1004
Generic name (nonproprietary): dairy mix
Active ingredients: Sus scrofa adrenal gland — 6 [hp_X]/59mLCorticotropin — 6 [hp_X]/59mLHistamine dihydrochloride — 12 [hp_X]/59mLBeef liver — 6 [hp_X]/59mLCasein, Lactococcus lactis cultured, Aged — 6 [hp_X]/59mLBlue tilapia whole — 6 [hp_X]/59mLCasein, Lactococcus lactis cultured, Penicillium camemberti cultured, Aged — 6 [hp_X]/59mLCasein, Lactococcus lactis cultured — 6 [hp_X]/59mLCow milk fat — 6 [hp_X]/59mLCasein, Streptococcus thermophilus cultured, Propionibacterium freudenreichii subsp. Shermanii cultured, Aged — 6 [hp_X]/59mLWhey — 6 [hp_X]/59mLSwiss chard — 6 [hp_X]/59mLCow milk — 6 [hp_X]/59mLGoat milk — 6 [hp_X]/59mLHuman milk — 6 [hp_X]/59mL
Dosage form: Liquid
Route: Oral
Labeler: Professional Complementary Health FormulasNDC labeler code 63083
Product type: Over-the-counter drug
Marketing category: Unapproved homeopathic
Marketing start: Aug 15, 1984
Listing expires: Dec 31, 2027
Other FDA classes: Adrenocorticotropic Hormone (Chemical structure)Allergens (Chemical structure)Allergens (Chemical structure)Allergens (Chemical structure)Allergens (Chemical structure)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Cell-mediated Immunity (Physiologic effect)Dietary Proteins (Chemical structure)Dietary Proteins (Chemical structure)Dietary Proteins (Chemical structure)Dietary Proteins (Chemical structure)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Increased Histamine Release (Physiologic effect)Meat Proteins (EXT)Milk Proteins (Chemical structure)Milk Proteins (Chemical structure)Milk Proteins (Chemical structure)
Identifiers: Product ID 63083-1004_b489dd5e-d223-41db-896f-930b1583a894SPL ID b489dd5e-d223-41db-896f-930b1583a894SPL set ID d77ee02b-faf4-4af5-bf51-aeb41d99f3ffUNII 398IYQ16YV, K0U68Q2TXA, 3POA0Q644U, W8N8R55022, CJP9NL7JSJ, 003ABL14YC, G44KTI7KIS, 489F5JNV5B, 463JZS0XJ3, EV7Y02KOMA, 8617Z5FMF6, 0FF8N9C1NY, 917J3173FT, XE5K5I4RP7, 1XCH439UQR
Pharmacologic class: Adrenocorticotropic Hormone; Non-Standardized Food 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. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N463083100402 followed by a unit qualifier and the quantity

Package 63083-1004-02. 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 Jan 8, 2026.

Indications (excerpt from the label)

INDICATIONS For the temporary relief of gas, bloating, diarrhea, and itching of the nose or throat due to sensitivity to dairy products.*

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 63083-1004

What is NDC 63083-1004?: 63083-1004 is the product NDC for Dairy Mix 1004 (dairy mix), Sus scrofa adrenal gland 6 [hp_X]/59mL + 14 more ingredients liquid, listed with the FDA by Professional Complementary Health Formulas. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Dairy Mix 1004 (Dairy Mix).
What is the active ingredient?: Sus scrofa adrenal gland, Corticotropin, Histamine dihydrochloride, Beef liver, Casein, Lactococcus lactis cultured, Aged, Blue tilapia whole, Casein, Lactococcus lactis cultured, Penicillium camemberti cultured, Aged, Casein, Lactococcus lactis cultured, Cow milk fat, Casein, Streptococcus thermophilus cultured, Propionibacterium freudenreichii subsp. Shermanii cultured, Aged, Whey, Swiss chard, Cow milk, Goat milk, Human milk.
Who is the labeler?: Professional Complementary Health Formulas, NDC labeler code 63083. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Dairy Mix 1004?: None: this is the only finished product listed under this name.
Is there a related HCPCS / J-code?: Not in Med-Code's curated HCPCS directory. See Billing references above.

Dairy Mix 1004 (Dairy mix) NDC 63083-1004