What is NDC 42794-028?

42794-028 is the product NDC for Disulfiram, Disulfiram 250 mg/1 tablet, listed with the FDA by Sigmapharm Laboratories, LLC. It has 1 package NDC, shown above in 10- and 11-digit form.

Sigmapharm Laboratories, LLC, NDC labeler code 42794. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.

What other NDCs exist for Disulfiram?

6 other product NDCs are listed under this name.

Is there a related HCPCS / J-code?

Not in Med-Code's curated HCPCS directory.

Disulfiram NDC 42794-028 | National Drug Code

NDC codes

FDA NDC Directory

Product NDC (as listed)42794-028Labeler and product segments. Claims need a package NDC.

Product NDC at billing width42794-0028Add 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
42794-028-08	42794002808	30 TABLET in 1 BOTTLE (42794-028-08)Marketed from Nov 1, 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): Disulfiram
Generic name (nonproprietary): disulfiram
Active ingredients: Disulfiram — 250 mg/1
Dosage form: Tablet
Route: Oral
Labeler: Sigmapharm Laboratories, LLCNDC labeler code 42794
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 091619
Marketing start: Nov 1, 2021
Listing expires: Dec 31, 2026
Other FDA classes: Acetyl Aldehyde Dehydrogenase Inhibitors (Mechanism)
Identifiers: Product ID 42794-028_20208d67-134d-2cc1-e063-6394a90a59beSPL ID 20208d67-134d-2cc1-e063-6394a90a59beSPL set ID 40f5497f-fe84-43b2-8ff4-32d59edf3917RxCUI 197623, 197624UNII TR3MLJ1UAIUPC 0342794028083
Pharmacologic class: Aldehyde Dehydrogenase 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

N442794002808 followed by a unit qualifier and the quantity

Package 42794-0028-08. 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 Aug 20, 2024. This label includes a boxed warning.

Indications (excerpt from the label)

INDICATIONS AND USAGE: Disulfiram is an aid in the management of selected chronic alcohol patients who want to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment may be applied to best advantage. Disulfiram is not a cure for alcoholism. When used alone, without proper motivation and supportive therapy, it is unlikely that it will have any substantive effect on the drinking pattern of the chronic alcoholic.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 42794-028

What is NDC 42794-028?: 42794-028 is the product NDC for Disulfiram, Disulfiram 250 mg/1 tablet, listed with the FDA by Sigmapharm Laboratories, LLC. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?: Disulfiram.
What is the active ingredient?: Disulfiram.
Who is the labeler?: Sigmapharm Laboratories, LLC, NDC labeler code 42794. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Disulfiram?: 6 other product NDCs are listed under this name. See all Disulfiram NDCs.
Is there a related HCPCS / J-code?: Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Disulfiram NDCs
Product	Strength	Form · route	Labeler	Product NDC	Package NDCs (11-digit)
Disulfiram	Disulfiram 500 mg/1	TabletOral	Sigmapharm Laboratories, LLC	42794-029	42794-0029-08
Disulfiram	Disulfiram 250 mg/1	TabletOral	Alvogen Inc.	47781-607	47781-0607-30
Disulfiram	Disulfiram 250 mg/1	TabletOral	Bryant Ranch Prepack	63629-5466	63629-5466-01
Disulfiram	Disulfiram 250 mg/1	TabletOral	Golden State Medical Supply, Inc.	60429-196	60429-0196-0160429-0196-30
Disulfiram	Disulfiram 250 mg/1	TabletOral	Chartwell RX, LLC	62135-431	62135-0431-3062135-0431-90
Disulfiram	Disulfiram 500 mg/1	TabletOral	Chartwell RX, LLC	62135-432	62135-0432-3062135-0432-90

Other NDCs under ANDA 091619

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

FDA NDC Directory listings under ANDA 091619
Product	Strength	Form · route	Labeler	Product NDC
Disulfiram	Disulfiram 500 mg/1	TabletOral	Sigmapharm Laboratories, LLC	42794-029