NDC codes

FDA NDC Directory
Product NDC (as listed)0456-2200Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00456-2200Add 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
0456-2200-07004562200071 BLISTER PACK in 1 CARTON (0456-2200-07) / 1 KIT in 1 BLISTER PACK (0456-2200-65) * 2 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (0456-2220-00) * 5 CAPSULE, EXTENDED RELEASE in 1 BLISTER PACK (0456-2240-00)Marketed from Mar 24, 2023 · Sample package

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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)
Fetzima
Generic name (nonproprietary)
levomilnacipran hydrochloride
Dosage form
Kit
Route
Oral
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 204168
Marketing start
Listing expires
Identifiers
Product ID 0456-2200_b4f9c587-d1eb-462b-bad2-ed0ce6d76c57SPL ID b4f9c587-d1eb-462b-bad2-ed0ce6d76c57SPL set ID f371258d-91b3-4b6a-ac99-434a1964c3afRxCUI 1433217, 1433223, 1433227, 1433229, 1433233, 1433235, 1433239, 1433241, 1433249, 1433250, 2636817, 2636818UNII 371U2ZK31UUPC 0304562240301

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

N400456220007 followed by a unit qualifier and the quantity

Package 00456-2200-07. 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 . This label includes a boxed warning.

Indications (excerpt from the label)

FETZIMA ® is indicated for the treatment of major depressive disorder (MDD) in adults [see Clinical Studies ( 14 )]. Limitation of Use: FETZIMA is not approved for the management of fibromyalgia. The efficacy and safety of FETZIMA for the management of fibromyalgia have not been established. FETZIMA is a serotonin and norepinephrine reuptake inhibitor (SNRI) indicated for the treatment of Major Depressive Disorder (MDD) in adults ( 1 ). Limitation of Use : FETZIMA is not approved for the management of fibromyalgia. The efficacy and safety of FETZIMA for the management of fibromyalgia have not been established ( 1 ).

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 204168

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

FDA NDC Directory listings under NDA 204168
ProductStrengthForm · routeLabelerProduct NDC
Fetzimalevomilnacipran hydrochloride—KitOralAllergan, Inc.0456-2202
Fetzimalevomilnacipran hydrochlorideLevomilnacipran hydrochloride 120 mg/1Capsule, Extended releaseOralAllergan, Inc.0456-2212
Fetzimalevomilnacipran hydrochlorideLevomilnacipran hydrochloride 20 mg/1Capsule, Extended releaseOralAllergan, Inc.0456-2220
Fetzimalevomilnacipran hydrochlorideLevomilnacipran hydrochloride 40 mg/1Capsule, Extended releaseOralAllergan, Inc.0456-2240
Fetzimalevomilnacipran hydrochlorideLevomilnacipran hydrochloride 80 mg/1Capsule, Extended releaseOralAllergan, Inc.0456-2280

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