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How to report NDC on a claim On a CMS-1500 form, report NDC information in the service line using the qualifier format: Qualifier : N4 (NDC qualifier for drug identification) NDC number : 11-digit format (5-4-2 format: labeler-product-package) Unit of measure qualifier : UN (units), ML (milliliters), GR (grams), or F2 (international units) as applicable to digoxin dosing Quantity : Actual quantity administered, not the vial size On UB-04 institutional claims, institutional claims typically carry the NDC in Form Locator 43 or in the drug detail lines depending on the claim format
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Note the date and approximate duration each time the vial spends time outside the fridge beyond routine injections
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