NDC codes

FDA NDC Directory
Product NDC (as listed)76472-3004Labeler and product segments. Claims need a package NDC.
Product NDC at billing width76472-3004Add 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
76472-3004-17647230040180 PELLET in 1 CYLINDER (76472-3004-1)Marketed from Nov 30, 2011

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)
Arsenicum Album 200ckSuffix: 200ck
Generic name (nonproprietary)
arsenic trioxide
Active ingredients
Arsenic trioxide — 200 [kp_C]/1
Dosage form
Pellet
Route
Sublingual
Labeler
SEVENE USA
Product type
Over-the-counter drug
Marketing category
Unapproved homeopathic
Marketing start
Listing expires
Identifiers
Product ID 76472-3004_2ddc212b-814c-d790-e063-6394a90aa58eSPL ID 2ddc212b-814c-d790-e063-6394a90aa58eSPL set ID c8d6dcbf-a5a9-5231-e053-2a95a90a7354UNII S7V92P67HOUPC 0850022941238

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

N476472300401 followed by a unit qualifier and the quantity

Package 76472-3004-01. 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)

USE Condition listed above or as directed by a physician.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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