Acyclovir NDC 17856-0083

NDC codes

FDA NDC Directory

Product NDC (as listed)17856-0083Labeler and product segments. Claims need a package NDC.

Product NDC at billing width17856-0083Add 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
17856-0083-1	17856008301	72 CUP, UNIT-DOSE in 1 BOX, UNIT-DOSE (17856-0083-1) / 5 mL in 1 CUP, UNIT-DOSE (17856-0083-4)Marketed from Apr 16, 2024
17856-0083-2	17856008302	72 CUP, UNIT-DOSE in 1 BOX, UNIT-DOSE (17856-0083-2) / 10 mL in 1 CUP, UNIT-DOSE (17856-0083-3)Marketed from Apr 16, 2024

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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 — 200 mg/5mL
Dosage form: Suspension
Route: Oral
Labeler: ATLANTIC BIOLOGICALS CORP.
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 074738
Marketing start: Sep 3, 2002
Listing expires: Dec 31, 2027
Other FDA classes: DNA Polymerase Inhibitors (Mechanism)Nucleoside Analog (EXT)
Identifiers: Product ID 17856-0083_564301ba-f108-9d33-e063-6294a90a24f5SPL ID 564301ba-f108-9d33-e063-6294a90a24f5SPL set ID da5a809c-6ddc-4609-9a34-ccb3d2d43976RxCUI 307730UNII 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

N417856008301 followed by a unit qualifier and the quantity

Package 17856-0083-01. 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.