NDC codes

FDA NDC Directory
Product NDC (as listed)71205-087Labeler and product segments. Claims need a package NDC.
Product NDC at billing width71205-0087Add 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
71205-087-157120500871515 CAPSULE in 1 BOTTLE, PLASTIC (71205-087-15)Marketed from Aug 1, 2018
71205-087-207120500872020 CAPSULE in 1 BOTTLE, PLASTIC (71205-087-20)Marketed from Aug 1, 2018
71205-087-307120500873030 CAPSULE in 1 BOTTLE, PLASTIC (71205-087-30)Marketed from Aug 1, 2018
71205-087-607120500876060 CAPSULE in 1 BOTTLE, PLASTIC (71205-087-60)Marketed from Aug 1, 2018
71205-087-907120500879090 CAPSULE in 1 BOTTLE, PLASTIC (71205-087-90)Marketed from Aug 1, 2018

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)
Hydroxyzine Pamoate
Generic name (nonproprietary)
hydroxyzine pamoate
Active ingredients
Hydroxyzine pamoate — 25 mg/1
Dosage form
Capsule
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 040156
Marketing start
Listing expires
Other FDA classes
Histamine Receptor Antagonists (Mechanism)
Identifiers
Product ID 71205-087_a4ff5eef-8452-42aa-8127-32e3c56c2b2bSPL ID a4ff5eef-8452-42aa-8127-32e3c56c2b2bSPL set ID 04657694-e8a8-4e52-a179-cfe752819760RxCUI 995253UNII M20215MUFRUPC 0371205087302
Pharmacologic class
Antihistamine

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

N471205008715 followed by a unit qualifier and the quantity

Package 71205-0087-15. 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 For symptomatic relief of anxiety and tension associated with psychoneurosis and as an adjunct in organic disease states in which anxiety is manifested. Useful in the management of pruritus due to allergic conditions such as chronic urticaria and atopic and contact dermatoses, and in histamine-mediated pruritus. As a sedative when used as premedication and following general anesthesia, Hydroxyzine may potentiate meperidine (Demerol ® ) and barbiturates , so their use in pre-anesthetic adjunctive therapy should be modified on an individual basis. Atropine and other belladonna alkaloids are not affected by the drug. Hydroxyzine is not known to interfere with the action of digitalis…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 040156

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

FDA NDC Directory listings under ANDA 040156
ProductStrengthForm · routeLabelerProduct NDC
Hydroxyzine PamoateHydroxyzine pamoate 50 mg/1CapsuleOralAvPAK50268-399
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralAmneal Pharmaceuticals of New York LLC0115-1803
Hydroxyzine PamoateHydroxyzine pamoate 50 mg/1CapsuleOralAmneal Pharmaceuticals of New York LLC0115-1804
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralAvPAK50268-398
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralA-S Medication Solutions50090-4579
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralBryant Ranch Prepack71335-0998
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralProficient Rx LP71205-123
Hydroxyzine PamoateHydroxyzine pamoate 50 mg/1CapsuleOralBryant Ranch Prepack71335-1923
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralNCS HealthCare of KY, LLC dba Vangard Labs0615-8419
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralAphena Pharma Solutions - Tennessee, LLC71610-217
Hydroxyzine PamoateHydroxyzine pamoate 50 mg/1CapsuleOralNCS HealthCare of KY, LLC dba Vangard Labs0615-8420
Hydroxyzine PamoateHydroxyzine pamoate 25 mg/1CapsuleOralNuCare Pharmaceuticals,Inc.68071-4915
Hydroxyzine PamoateHydroxyzine pamoate 50 mg/1CapsuleOralDirectRx72189-315

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