NDC codes

FDA NDC Directory
Product NDC (as listed)17856-4024Labeler and product segments. Claims need a package NDC.
Product NDC at billing width17856-4024Add 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
17856-4024-11785640240172 CUP, UNIT-DOSE in 1 CASE (17856-4024-1) / 5 mL in 1 CUP, UNIT-DOSEMarketed from Apr 24, 2026

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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)
Promethazine Hydrochloride and Dextromethorphan Hydrobromide
Generic name (nonproprietary)
promethazine hydrochloride and dextromethorphan hydrobromide
Active ingredients
Promethazine hydrochloride — 6.25 mg/5mLDextromethorphan hydrobromide — 15 mg/5mL
Dosage form
Syrup
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 088864
Marketing start
Listing expires
Other FDA classes
Phenothiazines (Chemical structure)Sigma-1 Receptor Agonists (Mechanism)Uncompetitive NMDA Receptor Antagonists (Mechanism)
Identifiers
Product ID 17856-4024_50223b67-c0bd-f577-e063-6394a90a8d8fSPL ID 50223b67-c0bd-f577-e063-6394a90a8d8fSPL set ID 5022379d-05ef-63f2-e063-6294a90a2189RxCUI 991528UNII R61ZEH7I1I, 9D2RTI9KYH
Pharmacologic class
Phenothiazine; Sigma-1 Agonist; Uncompetitive N-methyl-D-aspartate Receptor Antagonist

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

N417856402401 followed by a unit qualifier and the quantity

Package 17856-4024-01. 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 Promethazine hydrochloride and dextromethorphan hydrobromide syrup is indicated for the temporary relief of coughs and upper respiratory symptoms associated with allergy or the common cold.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 088864

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

FDA NDC Directory listings under ANDA 088864
ProductStrengthForm · routeLabelerProduct NDC
Promethazine Hydrochloride and Dextromethorphan HydrobromidePromethazine hydrochloride 6.25 mg/5mL; Dextromethorphan hydrobromide 15 mg/5mLSyrupOralXttrium Laboratories, Inc0116-4024
Promethazine Hydrochloride and Dextromethorphan HydrobromidePromethazine hydrochloride 6.25 mg/5mL; Dextromethorphan hydrobromide 15 mg/5mLSyrupOralA-S Medication Solutions50090-7658
Promethazine Hydrochloride and Dextromethorphan HydrobromidePromethazine hydrochloride 6.25 mg/5mL; Dextromethorphan hydrobromide 15 mg/5mLSyrupOralA-S Medication Solutions50090-6467

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