Over-the-counter drug · OTC MONOGRAPH DRUG
Allergy Relief Dye Free (Diphenhydramine hcl) NDC 79903-057
Diphenhydramine hydrochloride 25 mg/1 · Capsule, Liquid filled · Oral · Wal-Mart Stores Inc
NDC codes
FDA NDC DirectoryProduct NDC (as listed)79903-057Labeler and product segments. Claims need a package NDC.
Product NDC at billing width79903-0057Add the package segment from the table below.
| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 79903-057-24 | 79903005724 | 2 BLISTER PACK in 1 CARTON (79903-057-24) / 12 CAPSULE, LIQUID FILLED in 1 BLISTER PACKMarketed from Jan 28, 2021 |
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)
- Allergy Relief Dye FreeSuffix: Dye Free
- Generic name (nonproprietary)
- diphenhydramine hcl
- Active ingredients
- Diphenhydramine hydrochloride — 25 mg/1
- Dosage form
- Capsule, Liquid filled
- Route
- Oral
- Labeler
- Wal-Mart Stores IncNDC labeler code 79903
- Product type
- Over-the-counter drug
- Marketing category
- OTC monograph drugApplication M 012
- Marketing start
- Marketing end
- Other FDA classes
- Histamine H1 Receptor Antagonists (Mechanism)
- Identifiers
- Product ID 79903-057_494da573-ca99-c2e4-e063-6294a90ab856SPL ID 494da573-ca99-c2e4-e063-6294a90ab856SPL set ID 870e6bcb-84ab-45e0-ae57-08a9a182eb0bRxCUI 1049909UNII TC2D6JAD40
- Pharmacologic class
- Histamine-1 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
N479903005724followed by a unit qualifier and the quantityPackage 79903-0057-24. 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)
Uses temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: sneezing, runny nose, itchy, watery eyes, itching of the nose or throat temporarily relieves these symptoms due to hay fever or other upper respiratory allergies: sneezing, runny nose
Excerpt only. Read the full label for complete information.
About NDC 79903-057
- What is NDC 79903-057?
- 79903-057 is the product NDC for Allergy Relief Dye Free (diphenhydramine hcl), Diphenhydramine hydrochloride 25 mg/1 capsule, liquid filled, listed with the FDA by Wal-Mart Stores Inc. It has 1 package NDC, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- Allergy Relief Dye Free (Diphenhydramine HCl).
- What is the active ingredient?
- Diphenhydramine hydrochloride.
- Who is the labeler?
- Wal-Mart Stores Inc, NDC labeler code 79903. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for Allergy Relief Dye Free?
- 4 other product NDCs are listed under this name. See all Allergy Relief Dye Free NDCs.
- Is there a related HCPCS / J-code?
- Not in Med-Code's curated HCPCS directory. See Billing references above.
Related NDCs: other Allergy Relief Dye Free products
Other finished products listed under the same name: strengths, forms and labelers.
| Product | Strength | Form · route | Labeler | Product NDC | Package NDCs (11-digit) |
|---|---|---|---|---|---|
| Allergy Relief Dye Freediphenhydramine hydrochloride 25mg | Diphenhydramine hydrochloride 25 mg/1 | Capsule, Liquid filledOral | Walgreens | 0363-6682 | 00363-6682-2400363-6682-48 |
| Allergy Relief Dye Freediphenhydramine hcl | Diphenhydramine hydrochloride 25 mg/1 | Capsule, Liquid filledOral | Wal-Mart Stores Inc | 79903-193 | 79903-0193-48 |
| Allergy Relief Dye Freediphenhydramine hcl | Diphenhydramine hydrochloride 25 mg/1 | Capsule, Liquid filledOral | WALGREENS | 0363-1170 | 00363-1170-2400363-1170-48 |
| Allergy Relief Dye-Freediphenhydramine hcl | Diphenhydramine hydrochloride 25 mg/1 | Tablet, Film coatedOral | CVS Pharmacy | 59779-614 | 59779-0614-06 |
Other NDCs under M 012
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
| Product | Strength | Form · route | Labeler | Product NDC |
|---|---|---|---|---|
| Theraflu Flu Relief Max Strength Daytime Nighttime Combo Packacetaminophen, dextromethorphan hbr, and acetaminophen, chlorpheniramine maleate, dextromethorphan hbr | — | Kit | Haleon US Holdings LLC | 0067-7923 |
| QUALITY CHOICE DayTime Severe Cold and Fluacetaminophen, dextromethorphan hydrobromide, guaifenesin, phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 3 more ingredients | Capsule, Liquid filledOral | Chain Drug Marketing Association, Inc. | 83324-037 |
| SudoGestpseudoephedrine hcl | Pseudoephedrine hydrochloride 30 mg/1 | Tablet, Film coatedOral | Major Pharmaceuticals | 0904-5053 |
| Cold and Flu Relief Daytimeacetaminophen, dextromethorphan hydrobromide, phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 2 more ingredients | Capsule, Liquid filledOral | H E B | 37808-848 |
| Maximum Strength Mucus Reliefdextromethorphan hbr, guaifenesin | Dextromethorphan hydrobromide 20 mg/20mL; Guaifenesin 400 mg/20mL | LiquidOral | Hyvee Inc | 42507-630 |
| CVS PHARMACY Childrens Allergy Chewsdiphenhydramine hcl | Diphenhydramine hydrochloride 12.5 mg/1 | Tablet, ChewableOral | CVS PHARMACY, INC. | 51316-154 |
| Natural Honey Lemon with Echinacea Cough Suppressant Throat Dropsmenthol | Menthol 3.5 mg/1 | LozengeOral | Ricola Ag | 54305-467 |
| Cold and Fluacetaminophen, dextromethorphan hbr, doxylamine succinate | Acetaminophen 650 mg/30mL + 2 more ingredients | SolutionOral | ARMY AND AIR FORCE EXCHANGE SERVICE | 55301-310 |
| Giltuss Childrens MultiSymptom Cold and Fluacetaminophen, chlorpheniramine maleate, dextromethorphan hydrobromide, phenylephrine hydrochloride | Chlorpheniramine maleate 2 mg/5mL + 3 more ingredients | SolutionOral | Giltuss Pharmaceutical Corp | 58552-137 |
| Cough Dropsmenthol | Menthol 7.5 mg/1 | PastilleOral | Topco Associates LLC | 76162-027 |
| Mucinex Nightshift Severe Cold and Fluacetaminophen, dextromethorphan hydrobromide, phenylephrine hydrochloride, and triprolidine hydrochloride | Acetaminophen 650 mg/20mL + 3 more ingredients | SolutionOral | Reckitt Benckiser LLC | 63824-504 |
| Childrens Mucus and Cough Reliefguaifenesin and dextromethorphan hydrobromide | Dextromethorphan hydrobromide 5 mg/5mL; Guaifenesin 100 mg/5mL | LiquidOral | Chain Drug Manufacturing Assn | 63868-771 |
| Childrens Cold and Allergybrompheniramine maleate, phenylephrine hcl | Brompheniramine maleate 2 mg/10mL; Phenylephrine hydrochloride 5 mg/10mL | LiquidOral | CVS Pharmacy | 69842-779 |
| Cough and Cold Therapy For Kidscamphor, menthol, eucalyptus oil | Camphor (Natural) 4.7 g/100g + 2 more ingredients | OintmentTopical | Everlaan Organics Inc | 83670-201 |
| QUALITY CHOICE Cough Drops Vanilla Honeymenthol | Menthol, Unspecified form 2.5 mg/1 | LozengeOral | Chain Drug Marketing Association, Inc. | 83324-308 |
| Refenesen Mucus Relief DMdextromethorphan hydrobromide / guaifenesin | Dextromethorphan hydrobromide 20 mg/1; Guaifenesin 400 mg/1 | TabletOral | Reese Pharmaceutical Co | 10956-846 |
| Daytime Severe Cold And Flu Maximum Strengthacetaminophen, dextromethorphan hydrobromide, guaifenesin, and phenylephrine hydrochloride | Acetaminophen 325 mg/1 + 3 more ingredients | Tablet, CoatedOral | HEB | 37808-178 |
| Throat Comfort Lemon Mint Ginger Dropsmenthol | Menthol 3.4 mg/1 | LozengeOral | Ricola Ag | 54305-341 |
| dg health night time cold and flu reliefacetaminophen, dextromethorphan hbr, doxylamine succinate | Acetaminophen 650 mg/30mL + 2 more ingredients | SolutionOral | Dolgencorp Inc | 55910-335 |
| Allergy Reliefdiphenhydramine hcl | Diphenhydramine hydrochloride 25 mg/1 | Tablet, Film coatedOral | Strategic Sourcing Services LLC | 70677-1014 |
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