Livalo (pitavastatin calcium) NDC 66869-104

NDC codes

FDA NDC Directory

Product NDC (as listed)66869-104Labeler and product segments. Claims need a package NDC.

Product NDC at billing width66869-0104Add 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
66869-104-90	66869010490	90 TABLET, FILM COATED in 1 BOTTLE, DISPENSING (66869-104-90)Marketed from May 16, 2019

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): Livalo
Generic name (nonproprietary): pitavastatin calcium
Active ingredients: Pitavastatin calcium — 1.045 mg/1
Dosage form: Tablet, Film coated
Route: Oral
Labeler: Kowa Pharmaceuticals America, Inc.
Product type: Prescription drug
Marketing category: NDA — New Drug ApplicationApplication NDA 022363
Marketing start: May 16, 2019
Listing expires: Dec 31, 2027
Other FDA classes: Hydroxymethylglutaryl-CoA Reductase Inhibitors (Mechanism)
Identifiers: Product ID 66869-104_aacce141-185f-4d20-adb1-6cca3a9c87c4SPL ID aacce141-185f-4d20-adb1-6cca3a9c87c4SPL set ID 44dcbf97-99ec-427c-ba50-207e0069d6d2RxCUI 861643, 861646, 861648, 861650, 861652, 861654UNII IYD54XEG3WUPC 0366869204905, 0366869404909, 0366869104908
Pharmacologic class: HMG-CoA Reductase 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

N466869010490 followed by a unit qualifier and the quantity

Package 66869-0104-90. 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 Mar 31, 2026.

Indications (excerpt from the label)

LIVALO is indicated as an adjunct to diet to reduce low-density lipoprotein cholesterol (LDL-C) in: Adults with primary hyperlipidemia. Adults and pediatric patients aged 8 years and older with heterozygous familial hypercholesterolemia (HeFH). LIVALO is a HMG-CoA reductase inhibitor (statin) indicated as an adjunct to diet to reduce low-density lipoprotein cholesterol (LDL-C) in: ( 1 ) Adults with primary hyperlipidemia. Adults and pediatric patients aged 8 years and older with heterozygous familial hypercholesterolemia (HeFH).

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 022363

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

FDA NDC Directory listings under NDA 022363
Product	Strength	Form · route	Labeler	Product NDC
Livalopitavastatin calcium	Pitavastatin calcium 4.18 mg/1	Tablet, Film coatedOral	Kowa Pharmaceuticals America, Inc.	66869-404
Livalopitavastatin calcium	Pitavastatin calcium 2.09 mg/1	Tablet, Film coatedOral	Kowa Pharmaceuticals America, Inc.	66869-204