Pantoprazole Sodium (pantoprazole) NDC 42708-104

NDC codes

FDA NDC Directory

Product NDC (as listed)42708-104Labeler and product segments. Claims need a package NDC.

Product NDC at billing width42708-0104Add 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
42708-104-30	42708010430	30 TABLET, DELAYED RELEASE in 1 BOTTLE (42708-104-30)Marketed from Nov 18, 2019 · Sample package

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): Pantoprazole Sodium
Generic name (nonproprietary): pantoprazole
Active ingredients: Pantoprazole sodium — 40 mg/1
Dosage form: Tablet, Delayed release
Route: Oral
Labeler: QPharma Inc
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 202882
Marketing start: Sep 10, 2014
Listing expires: Dec 31, 2026
Other FDA classes: Proton Pump Inhibitors (Mechanism)
Identifiers: Product ID 42708-104_459c8b98-1e98-7bad-e063-6394a90aaf17SPL ID 459c8b98-1e98-7bad-e063-6394a90aaf17SPL set ID b4a94a37-47c1-4dd9-9e4d-5b4a03480aa6RxCUI 314200UNII 6871619Q5X
Pharmacologic class: Proton Pump 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

N442708010430 followed by a unit qualifier and the quantity

Package 42708-0104-30. 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

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