Acitretin NDC 0115-1752

NDC codes

FDA NDC Directory

Product NDC (as listed)0115-1752Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00115-1752Add 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 NDC	11-digit (billing)	Package	Copy
0115-1752-08	00115175208	30 CAPSULE in 1 BOTTLE, PLASTIC (0115-1752-08)Marketed from Jan 4, 2016

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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): Acitretin
Generic name (nonproprietary): acitretin
Active ingredients: Acitretin — 22.5 mg/1
Dosage form: Capsule
Route: Oral
Labeler: Amneal Pharmaceuticals of New York LLC
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 202552
Marketing start: Jan 4, 2016
Listing expires: Dec 31, 2026
Other FDA classes: Retinoids (Chemical structure)
Identifiers: Product ID 0115-1752_233bc68a-a24e-4f19-8477-3a11e80e68dfSPL ID 233bc68a-a24e-4f19-8477-3a11e80e68dfSPL set ID 85507f6c-f802-479e-bacc-624b5136d092RxCUI 199689, 199690, 894859, 894863UNII LCH760E9T7UPC 0301151753082, 0301151752085
Pharmacologic class: Retinoid

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

NDC on a medical claim

N400115175208 followed by a unit qualifier and the quantity

Package 00115-1752-08. 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 Jan 23, 2024. This label includes a boxed warning.

Indications (excerpt from the label)

INDICATIONS AND USAGE Acitretin capsules are indicated for the treatment of severe psoriasis in adults. Because of significant adverse effects associated with its use, acitretin capsules should be prescribed only by those knowledgeable in the systemic use of retinoids. In females of reproductive potential, acitretin capsules should be reserved for non-pregnant patients who are unresponsive to other therapies or whose clinical condition contraindicates the use of other treatments (see boxed CONTRAINDICATIONS AND WARNINGS — acitretin capsules can cause severe birth defects). Most patients experience relapse of psoriasis after discontinuing therapy. Subsequent courses, when clinically indicated…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 202552

Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.

FDA NDC Directory listings under ANDA 202552
Product	Strength	Form · route	Labeler	Product NDC
Acitretin	Acitretin 25 mg/1	CapsuleOral	Amneal Pharmaceuticals of New York LLC	0115-1753
Acitretin	Acitretin 10 mg/1	CapsuleOral	Amneal Pharmaceuticals of New York LLC	0115-1750
Acitretin	Acitretin 17.5 mg/1	CapsuleOral	Amneal Pharmaceuticals of New York LLC	0115-1751