Acne Relief NDC 0220-9101

NDC codes

FDA NDC Directory

Product NDC (as listed)0220-9101Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00220-9101Add 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
0220-9101-43	00220910143	3 TUBE in 1 BOX (0220-9101-43) / 80 PELLET in 1 TUBEMarketed from May 16, 2022

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): Acne Relief
Generic name (nonproprietary): potassium bromide, syzygium jambos seed, selenium
Active ingredients: Potassium bromide — 30 [hp_C]/1Syzygium jambos seed — 6 [hp_C]/1Selenium — 6 [hp_C]/1
Dosage form: Pellet
Route: Oral
Labeler: Boiron
Product type: Over-the-counter drug
Marketing category: Unapproved homeopathic
Marketing start: May 16, 2022
Listing expires: Dec 31, 2026
Identifiers: Product ID 0220-9101_06ea67d8-b617-776b-e063-6294a90a3185SPL ID 06ea67d8-b617-776b-e063-6294a90a3185SPL set ID df21b4e0-8c14-1c4d-e053-2995a90a74c7UNII OSD78555ZM, 97P0H45869, H6241UJ22B

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

N400220910143 followed by a unit qualifier and the quantity

Package 00220-9101-43. 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 Oct 4, 2023.

Indications (excerpt from the label)

Uses* temporarily relieves and treats occasional symptoms of acne (pimples) such as: blackheads oily skin whiteheads risk of scarring breakouts associated with puberty and menstrual periods

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)