NDC codes

FDA NDC Directory
Product NDC (as listed)82804-012Labeler and product segments. Claims need a package NDC.
Product NDC at billing width82804-0012Add 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
82804-012-308280400123030 TABLET in 1 BOTTLE (82804-012-30)Marketed from Sep 21, 2023
82804-012-358280400123535 TABLET in 1 BOTTLE (82804-012-35)Marketed from Nov 16, 2023
82804-012-508280400125050 TABLET in 1 BOTTLE (82804-012-50)Marketed from Jul 9, 2025
82804-012-608280400126060 TABLET in 1 BOTTLE (82804-012-60)Marketed from Sep 21, 2023
82804-012-908280400129090 TABLET in 1 BOTTLE (82804-012-90)Marketed from Sep 21, 2023

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)
Acyclovir
Generic name (nonproprietary)
acyclovir
Active ingredients
Acyclovir — 800 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 210401
Marketing start
Listing expires
Other FDA classes
DNA Polymerase Inhibitors (Mechanism)Nucleoside Analog (EXT)
Identifiers
Product ID 82804-012_14b524cc-8610-480d-8ce1-ab11f2a9f4d0SPL ID 14b524cc-8610-480d-8ce1-ab11f2a9f4d0SPL set ID d0908b3c-f5dd-4113-9080-bb01abe13c9cRxCUI 197313UNII X4HES1O11FUPC 0382804012305
Pharmacologic class
Herpes Simplex Virus Nucleoside Analog DNA Polymerase Inhibitor; Herpes Zoster Virus Nucleoside Analog DNA Polymerase Inhibitor; Herpesvirus Nucleoside Analog DNA Polymerase 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

N482804001230 followed by a unit qualifier and the quantity

Package 82804-0012-30. 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 Herpes Zoster Infections Acyclovir is indicated for the acute treatment of herpes zoster (shingles). Genital Herpes Acyclovir is indicated for the treatment of initial episodes and the management of recurrent episodes of genital herpes. Chickenpox Acyclovir is indicated for the treatment of chickenpox (varicella).

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 210401

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

FDA NDC Directory listings under ANDA 210401
ProductStrengthForm · routeLabelerProduct NDC
AcyclovirAcyclovir 400 mg/1TabletOralBryant Ranch Prepack71335-3103
AcyclovirAcyclovir 800 mg/1TabletOralChartwell RX, LLC62135-019
AcyclovirAcyclovir 400 mg/1TabletOralRedpharm Drug67296-2162
AcyclovirAcyclovir 400 mg/1TabletOralPD-Rx Pharmaceuticals, Inc.72789-587
AcyclovirAcyclovir 400 mg/1TabletOralProficient Rx LP71205-472
AcyclovirAcyclovir 400 mg/1TabletOralProficient Rx LP82804-005
AcyclovirAcyclovir 800 mg/1TabletOralRedpharm Drug67296-2254
AcyclovirAcyclovir 800 mg/1TabletOralA-S Medication Solutions50090-6578
AcyclovirAcyclovir 800 mg/1TabletOralBryant Ranch Prepack71335-1222
AcyclovirAcyclovir 400 mg/1TabletOralWestminster Pharmaceuticals, LLC69367-137
AcyclovirAcyclovir 800 mg/1TabletOralWestminster Pharmaceuticals, LLC69367-138
AcyclovirAcyclovir 400 mg/1TabletOralA-S Medication Solutions50090-7276
AcyclovirAcyclovir 400 mg/1TabletOralA-S Medication Solutions50090-7275
AcyclovirAcyclovir 400 mg/1TabletOralA-S Medication Solutions50090-7277
AcyclovirAcyclovir 400 mg/1TabletOralPreferred Pharmaceuticals Inc68788-8724
AcyclovirAcyclovir 400 mg/1TabletOralYILING PHARMACEUTICAL, INC.69117-0018
AcyclovirAcyclovir 800 mg/1TabletOralYILING PHARMACEUTICAL, INC.69117-0019

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