acetazolamide NDC 0904-6663

NDC codes

FDA NDC Directory

Product NDC (as listed)0904-6663Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00904-6663Add 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
0904-6663-61	00904666361	100 BLISTER PACK in 1 CARTON (0904-6663-61) / 1 TABLET in 1 BLISTER PACKMarketed from Mar 15, 2013

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): acetazolamide
Generic name (nonproprietary): acetazolamide
Active ingredients: Acetazolamide — 250 mg/1
Dosage form: Tablet
Route: Oral
Labeler: Major Pharmaceuticals
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 205530
Marketing start: Mar 15, 2013
Listing expires: Dec 31, 2027
Other FDA classes: Carbonic Anhydrase Inhibitors (Mechanism)Sulfonamides (Chemical structure)
Identifiers: Product ID 0904-6663_17b05236-812a-49a8-a7c5-0b5c7c311dd3SPL ID 17b05236-812a-49a8-a7c5-0b5c7c311dd3SPL set ID 37135ba5-63fd-427f-9b4a-8b7d1009bbcaRxCUI 197304UNII O3FX965V0I
Pharmacologic class: Carbonic Anhydrase Inhibitor

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

N400904666361 followed by a unit qualifier and the quantity

Package 00904-6663-61. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

Other NDCs under ANDA 205530

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

FDA NDC Directory listings under ANDA 205530
Product	Strength	Form · route	Labeler	Product NDC
Acetazolamide	Acetazolamide 125 mg/1	TabletOral	Chartwell RX, LLC	62135-607
Acetazolamide	Acetazolamide 250 mg/1	TabletOral	Chartwell RX, LLC	62135-608
acetazolamide	Acetazolamide 125 mg/1	TabletOral	A-S Medication Solutions	50090-5617
acetazolamide	Acetazolamide 250 mg/1	TabletOral	AvKARE	42291-090
acetazolamide	Acetazolamide 125 mg/1	TabletOral	AvKARE	42291-089
acetazolamide	Acetazolamide 125 mg/1	TabletOral	Northwind Health Company, LLC	51655-331
acetazolamide	Acetazolamide 125 mg/1	TabletOral	Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.	23155-287
acetazolamide	Acetazolamide 250 mg/1	TabletOral	Heritage Pharmaceuticals Inc. d/b/a Avet Pharmaceuticals Inc.	23155-288