NDC codes

FDA NDC Directory
Product NDC (as listed)76420-922Labeler and product segments. Claims need a package NDC.
Product NDC at billing width76420-0922Add 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
76420-922-0176420092201100 CAPSULE in 1 BOTTLE (76420-922-01)Marketed from Feb 18, 2025
76420-922-307642009223030 CAPSULE in 1 BOTTLE (76420-922-30)Marketed from Feb 18, 2025
76420-922-607642009226060 CAPSULE in 1 BOTTLE (76420-922-60)Marketed from Feb 18, 2025
76420-922-907642009229090 CAPSULE in 1 BOTTLE (76420-922-90)Marketed from Feb 18, 2025

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 — 100 mg/1
Dosage form
Capsule
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 088488
Marketing start
Listing expires
Other FDA classes
Histamine Receptor Antagonists (Mechanism)
Identifiers
Product ID 76420-922_2e63fa75-efcf-d9ee-e063-6394a90ab2d0SPL ID 2e63fa75-efcf-d9ee-e063-6394a90ab2d0SPL set ID 82187031-779e-47bc-943c-eb1a1ef30a7aRxCUI 995232, 995253, 995278UNII M20215MUFR
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

N476420092201 followed by a unit qualifier and the quantity

Package 76420-0922-01. 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 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…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 088488

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

FDA NDC Directory listings under ANDA 088488
ProductStrengthForm · routeLabelerProduct NDC
Hydroxyzine PamoateHydroxyzine pamoate 100 mg/1CapsuleOralTeva Pharmaceuticals USA, Inc.0555-0324
Hydroxyzine PamoateHydroxyzine pamoate 100 mg/1CapsuleOralBryant Ranch Prepack63629-9244
Hydroxyzine PamoateHydroxyzine pamoate 100 mg/1CapsuleOralREMEDYREPACK INC.70518-2769

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