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Medicare NDC Entry Quick Reference: Electronic (837P): Loop 2410, LIN03 qualifier N4, followed by the 11-digit NDC Paper (CMS-1500): Box 19 format: N4[NDC number]*[unit][quantity] Example entry: N4 12345678901*ML*1.5 Per the CMS Claims Processing Manual guidance on drug claim requirements, failure to include the NDC on a Medicare claim results in denial of the drug J-code line item, not the administration code

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Discontinue use if any negative reaction occurs