Dr Simi Pain Relief 100 (acetaminophen) NDC 85786-102

NDC codes

FDA NDC Directory

Product NDC (as listed)85786-102Labeler and product segments. Claims need a package NDC.

Product NDC at billing width85786-0102Add 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
85786-102-90	85786010290	100 TABLET, COATED in 1 BOTTLE (85786-102-90)Marketed from Aug 13, 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): Dr Simi Pain Relief 100
Generic name (nonproprietary): acetaminophen
Active ingredients: Acetaminophen — 500 mg/1
Dosage form: Tablet, Coated
Route: Oral
Labeler: Farmacias De Similares TX LLC
Product type: Over-the-counter drug
Marketing category: OTC monograph drugApplication M 013
Marketing start: Aug 13, 2025
Listing expires: Dec 31, 2027
Identifiers: Product ID 85786-102_3c42e48d-cdb3-eb74-e063-6394a90a2940SPL ID 3c42e48d-cdb3-eb74-e063-6394a90a2940SPL set ID 3c42e48d-cdb2-eb74-e063-6394a90a2940RxCUI 198440UNII 362O9ITL9DUPC 0850070048828

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

N485786010290 followed by a unit qualifier and the quantity

Package 85786-0102-90. 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 Aug 13, 2025.

Indications (excerpt from the label)

Uses Temporarily relieves minor aches and pains due to: Headache Muscular aches Backache Minor pain of arthritis The comon cold Toothache Premenstrual and menstrual cramps Temporarily reduces fever.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under M 013

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

FDA NDC Directory listings under M 013
Product	Strength	Form · route	Labeler	Product NDC
equate pain relieveracetaminophen	Acetaminophen 325 mg/1	TabletOral	WALMART INC.	79903-299
Unishield Aspirinaspirin	Aspirin 325 mg/1	Tablet, Film coatedOral	Unishield	49314-1163
dg health aspirinaspirin	Aspirin 81 mg/1	Tablet, ChewableOral	Dolgencorp, LLC	55910-467
Nite-Time COLD/FLU ORIGINALacetaminophen, dextromethorphan hydrobromide, doxylamine succinate	Acetaminophen 650 mg/30mL + 2 more ingredients	LiquidOral	Salado Sales, Inc.	57243-501
Aspirina Cafeinaaspirin,caffeine	Caffeine 32.5 mg/1; Aspirin 500 mg/1	TabletOral	Bayer HealthCare LLC.	0280-0162
Aspirin Low Dose Safety Coatedaspirin	Aspirin 81 mg/1	Tablet, CoatedOral	Care One (Retail Business Services, LLC.)	72476-263
Acetaminophen	Acetaminophen 500 mg/1	TabletOral	WALMART INC	79903-296
Dolex Children Pain and Feveracetaminophen	Acetaminophen 160 mg/5mL	SuspensionOral	Pharmadel LLC	55758-026
Acetaminophen PM Extra Strengthacetaminophen and diphenhydramine hydrochloride	Acetaminophen 500 mg/1; Diphenhydramine hydrochloride 25 mg/1	Tablet, CoatedOral	WinCo Foods, LLC	67091-137
Aspirin Low Doseaspirin	Aspirin 81 mg/1	Tablet, ChewableOral	Walgreen Company	0363-0218
Acetaminophen	Acetaminophen 500 mg/1	TabletOral	Meijer Distribution Inc	79481-0780
Children Acetaminophen Oral Solutionacetaminophen	Acetaminophen 160 mg/5mL	LiquidOral	MAJOR PHARMACEUTICALS	0904-7014
Headache Relief Extra Strengthacetaminophen, aspirin, caffeine	Acetaminophen 250 mg/1 + 2 more ingredients	TabletOral	Safeway, Inc.	21130-586
Back and Body Extra Strengthaspirin, caffeine	Aspirin 500 mg/1; Caffeine 32.5 mg/1	Tablet, Film coatedOral	Meijer Distribution Inc	41250-143
TYLENOL Extra Strengthacetaminophen	Acetaminophen 960 mg/30mL	SuspensionOral	Kenvue Brands LLC	50580-187
Acetaminophen	Acetaminophen 325 mg/1	TabletOral	Prostat First Aid	58228-0061
Aspirin 81mgaspirin enteric coated tablets 81mg	Aspirin 81 mg/1	TabletOral	VITANE PHARMACEUTICALS, INC	60577-807
Acetaminophen PMacetaminophen, diphenhydramine hcl	Acetaminophen 500 mg/1; Diphenhydramine hydrochloride 25 mg/1	Tablet, CoatedOral	COSTCO WHOLESALE CORPORATION	63981-056
Childrens Pain and Fever, Grape flavoracetaminophen	Acetaminophen 160 mg/5mL	SuspensionOral	Walgreen Company	0363-0323
Amazon Basics Acetaminophenacetaminophen	Acetaminophen 500 mg/1	TabletOral	Amazon.com Services LLC	72288-008

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