NDC codes

FDA NDC Directory
Product NDC (as listed)50090-3250Labeler and product segments. Claims need a package NDC.
Product NDC at billing width50090-3250Add 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
50090-3250-0500903250002 TABLET in 1 BOTTLE (50090-3250-0)Marketed from Oct 15, 2018
50090-3250-25009032500225 TABLET in 1 BOTTLE (50090-3250-2)Marketed from Nov 8, 2017
50090-3250-35009032500350 TABLET in 1 BOTTLE (50090-3250-3)Marketed from Nov 8, 2017
50090-3250-45009032500415 TABLET in 1 BOTTLE (50090-3250-4)Marketed from Nov 8, 2017
50090-3250-55009032500530 TABLET in 1 BOTTLE (50090-3250-5)Marketed from Nov 8, 2017
50090-3250-65009032500660 TABLET in 1 BOTTLE (50090-3250-6)Marketed from Nov 8, 2017
50090-3250-95009032500945 TABLET in 1 BOTTLE (50090-3250-9)Marketed from Nov 8, 2017

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 — 400 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 204314
Marketing start
Listing expires
Other FDA classes
DNA Polymerase Inhibitors (Mechanism)Nucleoside Analog (EXT)
Identifiers
Product ID 50090-3250_0c61c8ca-1f35-4ffa-b0a1-888b08f47f5fSPL ID 0c61c8ca-1f35-4ffa-b0a1-888b08f47f5fSPL set ID c40a57b9-4cf1-4a69-abf3-eb99a7fcda00RxCUI 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

N450090325000 followed by a unit qualifier and the quantity

Package 50090-3250-00. 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)

INDICATIONS AND USAGE Herpes Zoster Infections: Acyclovir tablets are indicated for the acute treatment of herpes zoster (shingles). Genital Herpes: Acyclovir tablets are indicated for the treatment of initial episodes and the management of recurrent episodes of genital herpes. Chickenpox: Acyclovir tablets are indicated for the treatment of chickenpox (varicella).

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 204314

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

FDA NDC Directory listings under ANDA 204314
ProductStrengthForm · routeLabelerProduct NDC
acyclovirAcyclovir 800 mg/1TabletOralCoupler LLC67046-1487
acyclovirAcyclovir 400 mg/1TabletOralZydus Lifesciences Limited65841-802
acyclovirAcyclovir 800 mg/1TabletOralZydus Lifesciences Limited65841-803
acyclovirAcyclovir 800 mg/1TabletOralProficient Rx LP63187-366
acyclovirAcyclovir 400 mg/1TabletOralZydus Pharmaceuticals (USA) Inc.68382-791
acyclovirAcyclovir 800 mg/1TabletOralZydus Pharmaceuticals (USA) Inc.68382-792
acyclovirAcyclovir 400 mg/1TabletOralREMEDYREPACK INC.70518-1363
acyclovirAcyclovir 400 mg/1TabletOralA-S Medication Solutions50090-3254
acyclovirAcyclovir 800 mg/1TabletOralNorthwind Health Company, LLC82868-107
acyclovirAcyclovir 800 mg/1TabletOralREMEDYREPACK INC.70518-1614
acyclovirAcyclovir 800 mg/1TabletOralNuCare Pharmaceuticals, Inc.66267-399

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