Acetazolamide NDC 52817-200

NDC codes

FDA NDC Directory

Product NDC (as listed)52817-200Labeler and product segments. Claims need a package NDC.

Product NDC at billing width52817-0200Add 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
52817-200-00	52817020000	1000 TABLET in 1 BOTTLE, PLASTIC (52817-200-00)Marketed from Jun 1, 2021
52817-200-10	52817020010	100 TABLET in 1 BOTTLE, PLASTIC (52817-200-10)Marketed from Jun 1, 2021

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): Acetazolamide
Generic name (nonproprietary): acetazolamide
Active ingredients: Acetazolamide — 125 mg/1
Dosage form: Tablet
Route: Oral
Labeler: TRUPHARMA, LLC
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 211372
Marketing start: Apr 19, 2021
Listing expires: Dec 31, 2026
Other FDA classes: Carbonic Anhydrase Inhibitors (Mechanism)Sulfonamides (Chemical structure)
Identifiers: Product ID 52817-200_1df8bd81-54fe-44ea-98aa-5f13592dd8bdSPL ID 1df8bd81-54fe-44ea-98aa-5f13592dd8bdSPL set ID 4fcd428a-7bf3-4e75-a834-1bdf1078107fRxCUI 197303, 197304UNII O3FX965V0IUPC 0352817200105
Pharmacologic class: Carbonic Anhydrase 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

N452817020000 followed by a unit qualifier and the quantity

Package 52817-0200-00. 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 Jun 13, 2022.

Indications (excerpt from the label)

INDICATIONS AND USAGE For adjunctive treatment of: edema due to congestive heart failure; drug-induced edema; centrencephalic epilepsies (petit mal, unlocalized seizures); chronic simple (open-angle) glaucoma, secondary glaucoma, and preoperatively in acute angle-closure glaucoma where delay of surgery is desired in order to lower intraocular pressure. Acetazolamide tablets are also indicated for the prevention or amelioration of symptoms associated with acute mountain sickness in climbers attempting rapid ascent and in those who are very susceptible to acute mountain sickness despite gradual ascent.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 211372

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

FDA NDC Directory listings under ANDA 211372
Product	Strength	Form · route	Labeler	Product NDC
Acetazolamide	Acetazolamide 250 mg/1	TabletOral	TRUPHARMA, LLC	52817-201