NDC codes

FDA NDC Directory
Product NDC (as listed)77964-004Labeler and product segments. Claims need a package NDC.
Product NDC at billing width77964-0004Add 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
77964-004-017796400040150 mL in 1 CONTAINER (77964-004-01)Marketed from Feb 27, 2022

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)
FOASU Pink Y s RecoveryCream
Generic name (nonproprietary)
niacinamide, adenosine
Active ingredients
Adenosine — .04 g/100mLNiacinamide — 2 g/100mL
Dosage form
Cream
Route
Topical
Product type
Over-the-counter drug
Marketing category
Unapproved drug (other)
Marketing start
Listing expires
Other FDA classes
Adenosine Receptor Agonists (Mechanism)
Identifiers
Product ID 77964-004_d8fa269e-18ac-0889-e053-2995a90a31abSPL ID d8fa269e-18ac-0889-e053-2995a90a31abSPL set ID d8fa2f3f-52e1-47ef-e053-2995a90a2a94UNII K72T3FS567, 25X51I8RD4UPC 8809579912682
Pharmacologic class
Adenosine Receptor Agonist

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

NDC on a medical claim

N477964000401 followed by a unit qualifier and the quantity

Package 77964-0004-01. 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 apply proper amount to the skin

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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