NDC codes

FDA NDC Directory
Product NDC (as listed)0254-3022Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00254-3022Add 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 NDC11-digit (billing)PackageCopy
0254-3022-02002543022021 BOTTLE in 1 CARTON (0254-3022-02) / 60 CAPSULE in 1 BOTTLEMarketed from Oct 4, 2019

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)
Nitisinone
Generic name (nonproprietary)
nitisinone
Active ingredients
Nitisinone — 10 mg/1
Dosage form
Capsule
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 211041
Marketing start
Listing expires
Other FDA classes
Cytochrome P450 2C9 Inhibitors (Mechanism)Cytochrome P450 2E1 Inducers (Mechanism)Hydroxyphenylpyruvate Dioxygenase Inhibitors (Mechanism)Organic Anion Transporter 1 Inhibitors (Mechanism)Organic Anion Transporter 3 Inhibitors (Mechanism)
Identifiers
Product ID 0254-3022_403b3d85-e7be-4cc8-b286-bd0a099dae77SPL ID 403b3d85-e7be-4cc8-b286-bd0a099dae77SPL set ID 437868f5-1c9e-4b0f-8a03-77df8ac0900dRxCUI 351173, 351174, 351175UNII K5BN214699UPC 0302543022021, 0302543021024
Pharmacologic class
4-Hydroxyphenyl-Pyruvate Dioxygenase Inhibitor

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

N400254302202 followed by a unit qualifier and the quantity

Package 00254-3022-02. 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 .

Indications (excerpt from the label)

Nitisinone capsules are indicated for the treatment of adult and pediatric patients with hereditary tyrosinemia type 1 (HT-1) in combination with dietary restriction of tyrosine and phenylalanine. Nitisinone is a hydroxy-phenylpyruvate dioxygenase inhibitor indicated for the treatment of adult and pediatric patients with hereditary tyrosinemia type 1 (HT-1) in combination with dietary restriction of tyrosine and phenylalanine. (1)

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 211041

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

FDA NDC Directory listings under ANDA 211041
ProductStrengthForm · routeLabelerProduct NDC
NitisinoneNitisinone 2 mg/1CapsuleOralPar Health USA, LLC0254-3020
NitisinoneNitisinone 5 mg/1CapsuleOralBryant Ranch Prepack63629-2235
NitisinoneNitisinone 10 mg/1CapsuleOralBryant Ranch Prepack63629-2233
NitisinoneNitisinone 5 mg/1CapsuleOralPar Health USA, LLC0254-3021
NitisinoneNitisinone 2 mg/1CapsuleOralBryant Ranch Prepack63629-2234

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