NDC codes

FDA NDC Directory
Product NDC (as listed)42291-086Labeler and product segments. Claims need a package NDC.
Product NDC at billing width42291-0086Add 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
42291-086-304229100863030 CAPSULE in 1 BOTTLE (42291-086-30)Marketed from Oct 11, 2017

How the 11-digit form is made: The product segment has 3 digits, so one leading zero is added to it (5-3-2 → 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 — 10 mg/1
Dosage form
Capsule
Route
Oral
Labeler
AvKARE
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 204633
Marketing start
Listing expires
Other FDA classes
Retinoids (Chemical structure)
Identifiers
Product ID 42291-086_0e8b3503-2371-af12-e063-6294a90af0c0SPL ID 0e8b3503-2371-af12-e063-6294a90af0c0SPL set ID 6af396c2-af3e-436d-ba9a-583637495910RxCUI 199689, 199690, 894859UNII LCH760E9T7UPC 0342291086302, 0342291087309, 0342291088306
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

N442291008630 followed by a unit qualifier and the quantity

Package 42291-0086-30. 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 . This label includes a boxed warning.

Indications (excerpt from the label)

INDICATIONS AND USAGE Acitretin Capsules, USP are indicated for the treatment of severe psoriasis in adults. Because of significant adverse effects associated with its use, Acitretin Capsules, USP should be prescribed only by those knowledgeable in the systemic use of retinoids. In females of reproductive potential, Acitretin Capsules, USP 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, USP can cause severe birth defects). Most patients experience relapse of psoriasis after discontinuing therapy. Subsequent courses, when …

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 204633

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

FDA NDC Directory listings under ANDA 204633
ProductStrengthForm · routeLabelerProduct NDC
AcitretinAcitretin 10 mg/1CapsuleOralBryant Ranch Prepack72162-2222
AcitretinAcitretin 10 mg/1CapsuleOralSigmapharm Laboratories, LLC42794-080
AcitretinAcitretin 17.5 mg/1CapsuleOralSigmapharm Laboratories, LLC42794-081
AcitretinAcitretin 25 mg/1CapsuleOralSigmapharm Laboratories, LLC42794-083
AcitretinAcitretin 17.5 mg/1CapsuleOralAvKARE42291-087
AcitretinAcitretin 25 mg/1CapsuleOralBryant Ranch Prepack72162-2223
AcitretinAcitretin 25 mg/1CapsuleOralAvKARE42291-088
AcitretinAcitretin 17.5 mg/1CapsuleOralBryant Ranch Prepack72162-2224

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