Floriva Tablet, Chewable
NDC Package 52796-174-01

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Other Packages
    3. Frequently Asked Questions

Package Information

Floriva (vitamin a acetate, .beta.-carotene, ascorbic acid, cholecalciferol, .alpha.-tocopherol, thiamine, riboflavin, niacinamide, pyridoxine, levomefolate glucosamine, folic acid, cyanocobalamin, biotin, zinc gluconate, cupric oxide, and sodium fluoride) tablets is a medication a combination product of vitamins and fluoride. This formulation utilizes a tablet, chewable delivery system. Marketed by Bongeo Pharmaceuticals, Inc., this product is identified by NDC 52796-174.

Identification & Billing

NDC Package Code
52796-174-01
Package Description
1 BLISTER PACK in 1 CARTON / 1 TABLET, CHEWABLE in 1 BLISTER PACK
Product Code
52796-174
11-Digit Billing Format
52796017401

Clinical Specifications

Proprietary Name
Floriva
Non-Proprietary Name
Vitamin A Acetate, .beta.-carotene, Ascorbic Acid, Cholecalciferol, .alpha.-tocopherol, Thiamine, Riboflavin, Niacinamide, Pyridoxine, Levomefolate Glucosamine, Folic Acid, Cyanocobalamin, Biotin, Zinc Gluconate, Cupric Oxide, And Sodium Fluoride
Substance Name
.alpha.-tocopherol; Ascorbic Acid; Beta Carotene; Biotin; Cholecalciferol; Cupric Oxide; Cyanocobalamin; Folic Acid; Levomefolate Glucosamine; Niacinamide; Pyridoxine; Riboflavin; Sodium Fluoride; Thiamine; Vitamin A Acetate; Zinc Gluconate
Dosage Form
Tablet, Chewable - A solid dosage form containing medicinal substances with or without suitable diluents that is intended to be chewed, producing a pleasant tasting residue in the oral cavity that is easily swallowed and does not leave a bitter or unpleasant after-taste.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
Pharmacologic Class
Usage Information
This medication is a combination product of vitamins and fluoride. It is used in children to treat or prevent deficiency due to poor diet or low levels of fluoride in drinking water and other sources. Vitamins are important building blocks of the body and help keep you in good health. Fluoride is used to prevent dental cavities.

Regulatory & Marketing

Labeler Name
Bongeo Pharmaceuticals, Inc.
Product Type
Human Prescription Drug
Marketing Category
UNAPPROVED DRUG OTHER - An unapproved drug product in a marketing category that is not reflected on a particular list.
Start Marketing Date
10-15-2014
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Other Available Packages

The following commercial packages are registered under the same Product NDC (52796-174). Click a package code to view its specific billing and regulatory data.

52796-174-90
90 TABLET, CHEWABLE in 1 BOTTLE

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 52796-174-01 identifies a specific commercial package of 1 blister pack in 1 carton / 1 tablet, chewable in 1 blister pack of Floriva, a human prescription drug labeled by Bongeo Pharmaceuticals, Inc.. This tablet, chewable is formulated for oral use and contains .alpha.-tocopherol; ascorbic acid; beta carotene; biotin; cholecalciferol; cupric oxide; cyanocobalamin; folic acid; levomefolate glucosamine; niacinamide; pyridoxine; riboflavin; sodium fluoride; thiamine; vitamin a acetate; zinc gluconate as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Bongeo Pharmaceuticals, Inc. on October 15, 2014. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

This medication is a combination product of vitamins and fluoride. It is used in children to treat or prevent deficiency due to poor diet or low levels of fluoride in drinking water and other sources. Vitamins are important building blocks of the body and help keep you in good health. Fluoride is used to prevent dental cavities.

How is this Bongeo Pharmaceuticals, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 52796017401. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
52796-174-01
11-Digit CMS (5-4-2)
52796-0174-01

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.