NDC codes

FDA NDC Directory
Product NDC (as listed)0904-7507Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00904-7507Add 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
0904-7507-6100904750761100 BLISTER PACK in 1 CARTON (0904-7507-61) / 1 TABLET in 1 BLISTER PACKMarketed from Jan 28, 2025

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)
Acyclovir
Generic name (nonproprietary)
acyclovir
Active ingredients
Acyclovir — 400 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 203834
Marketing start
Listing expires
Other FDA classes
DNA Polymerase Inhibitors (Mechanism)Nucleoside Analog (EXT)
Identifiers
Product ID 0904-7507_a5909f5b-fb25-4050-990a-19d29eef0457SPL ID a5909f5b-fb25-4050-990a-19d29eef0457SPL set ID 46150f19-ce5d-42a0-80a7-f96fda2b9879RxCUI 197311UNII X4HES1O11F
Pharmacologic class
Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor; Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor; Herpesvirus Nucleoside Analog DNA Polymerase 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

N400904750761 followed by a unit qualifier and the quantity

Package 00904-7507-61. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

Other NDCs under ANDA 203834

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

FDA NDC Directory listings under ANDA 203834
ProductStrengthForm · routeLabelerProduct NDC
AcyclovirAcyclovir 400 mg/1TabletOralNuCare Pharmaceuticals,Inc.68071-1841
AcyclovirAcyclovir 800 mg/1TabletOralCamber Pharmaceuticals, Inc.31722-778
AcyclovirAcyclovir 400 mg/1TabletOralBryant Ranch Prepack71335-0323
AcyclovirAcyclovir 400 mg/1TabletOralCamber Pharmaceuticals, Inc.31722-777
AcyclovirAcyclovir 400 mg/1TabletOralProficient Rx LP63187-253
AcyclovirAcyclovir 400 mg/1TabletOralREMEDYREPACK INC.70518-2117
AcyclovirAcyclovir 800 mg/1TabletOralNuCare Pharmaceuticals, Inc.68071-3222
AcyclovirAcyclovir 400 mg/1TabletOralPD-Rx Pharmaceuticals, Inc.43063-928
AcyclovirAcyclovir 800 mg/1TabletOralSt. Mary's Medical Park Pharmacy60760-778
AcyclovirAcyclovir 400 mg/1TabletOralAdvanced Rx Pharmacy of Tennessee, LLC80425-0270
AcyclovirAcyclovir 800 mg/1TabletOralPharmPak, Inc.54348-624
AcyclovirAcyclovir 400 mg/1TabletOralPharmPak, Inc.54348-627
AcyclovirAcyclovir 800 mg/1TabletOralNorthwind Health Company, LLC51655-679
AcyclovirAcyclovir 400 mg/1TabletOralA-S Medication Solutions50090-6844
AcyclovirAcyclovir 400 mg/1TabletOralNuCare Pharmaceuticals,Inc.68071-4799
AcyclovirAcyclovir 800 mg/1TabletOralPreferred Pharmaceuticals, Inc.68788-7575
AcyclovirAcyclovir 400 mg/1TabletOralREMEDYREPACK INC.70518-2455
AcyclovirAcyclovir 800 mg/1TabletOralREMEDYREPACK INC.70518-2518
AcyclovirAcyclovir 800 mg/1TabletOralPD-Rx Pharmaceuticals, Inc.43063-589
AcyclovirAcyclovir 400 mg/1TabletOralNorthwind Health Company, LLC51655-300

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