NDC codes

FDA NDC Directory
Product NDC (as listed)0904-7253Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00904-7253Add 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
0904-7253-04009047253043 BLISTER PACK in 1 CARTON (0904-7253-04) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7253-35)Marketed from Jun 23, 2025
0904-7253-68009047253686 BLISTER PACK in 1 CARTON (0904-7253-68) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACK (0904-7253-35)Marketed from Jun 23, 2025

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)
Dabigatran Etexilate
Generic name (nonproprietary)
dabigatran etexilate
Active ingredients
Dabigatran etexilate mesylate — 75 mg/1
Dosage form
Capsule, Coated pellets
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 208040
Marketing start
Listing expires
Other FDA classes
Thrombin Inhibitors (Mechanism)
Identifiers
Product ID 0904-7253_869fd2f3-9357-4148-8b64-0cca96dd5f75SPL ID 869fd2f3-9357-4148-8b64-0cca96dd5f75SPL set ID b76b79ce-b7dd-4390-b40e-71ae6c477d10RxCUI 1037045, 1037179, 1723476UNII SC7NUW5IITUPC 0309047253043, 0309047255108
Pharmacologic class
Direct Thrombin 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

N400904725304 followed by a unit qualifier and the quantity

Package 00904-7253-04. 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)

Dabigatran Etexilate Capsules is a direct thrombin inhibitor indicated: To reduce the risk of stroke and systemic embolism in adult patients with non-valvular atrial fibrillation ( 1.1 ) For the treatment of deep venous thrombosis (DVT) and pulmonary embolism (PE) in adult patients who have been treated with a parenteral anticoagulant for 5 to 10 days ( 1.2 ) To reduce the risk of recurrence of DVT and PE in adult patients who have been previously treated ( 1.3 ) For the prophylaxis of DVT and PE in adult patients who have undergone hip replacement surgery ( 1.4 ) For the treatment of venous thromboembolic events (VTE) in pediatric patients 8 to less than 18 years of age who have been treate…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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