NDC 84415-010

NDC codes

FDA NDC Directory

Product NDC (as listed)84415-010Labeler and product segments. Claims need a package NDC.

Product NDC at billing width84415-0010Add 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
84415-010-01	84415001001	100 CUP, UNIT-DOSE in 1 BOX, UNIT-DOSE (84415-010-01) / 30 mL in 1 CUP, UNIT-DOSEMarketed from Jan 16, 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): Aluminum Hydroxide, Magnesium Hydroxide and Simethicone
Generic name (nonproprietary): aluminum hydroxide, magnesium hydroxide, and simethicone
Active ingredients: Aluminum hydroxide — 2400 mg/30mLMagnesium hydroxide — 2400 mg/30mLDimethicone — 240 mg/30mL
Dosage form: Suspension
Route: Oral
Labeler: Everpharm LLC
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M001.15
Marketing start: Jan 16, 2025
Listing expires: Dec 31, 2026
Other FDA classes: Increased Large Intestinal Motility (Physiologic effect)Inhibition Large Intestine Fluid/Electrolyte Absorption (Physiologic effect)Inhibition Small Intestine Fluid/Electrolyte Absorption (Physiologic effect)Magnesium Ion Exchange Activity (Mechanism)Osmotic Activity (Mechanism)Skin Barrier Activity (Physiologic effect)Stimulation Large Intestine Fluid/Electrolyte Secretion (Physiologic effect)
Identifiers: Product ID 84415-010_2bda8639-5512-d3fd-e063-6294a90a04eeSPL ID 2bda8639-5512-d3fd-e063-6294a90a04eeSPL set ID 2bda74cb-e77d-46bb-e063-6394a90af580RxCUI 237870, 307746UNII NBZ3QY004S, 92RU3N3Y1O, 5QB0T2IUN0
Pharmacologic class: Calculi Dissolution Agent; Osmotic Laxative

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

N484415001001 followed by a unit qualifier and the quantity

Package 84415-0010-01. 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 Jan 16, 2025.

Indications (excerpt from the label)

Uses relieves • heartburn • sour stomach • acid indigestion • the symptoms referred to as gas

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under M001.15

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

FDA NDC Directory listings under M001.15
Product	Strength	Form · route	Labeler	Product NDC
Aluminum Hydroxide, Magnesium Hydroxide and Simethiconealuminum hydroxide, magnesium hydroxide, and simethicone	Aluminum hydroxide 1200 mg/30mL + 2 more ingredients	SuspensionOral	Rising Pharma Holdings, Inc.	57237-316
Aluminum Hydroxide, Magnesium Hydroxide and Simethiconealuminum hydroxide, magnesium hydroxide, and simethicone	Aluminum hydroxide 2400 mg/30mL + 2 more ingredients	SuspensionOral	Rising Pharma Holdings, Inc.	57237-324

Aluminum Hydroxide, Magnesium Hydroxide and Simethicone NDC 84415-010