Leaky Gut Formula NDC 43742-2019

NDC codes

FDA NDC Directory

Product NDC (as listed)43742-2019Labeler and product segments. Claims need a package NDC.

Product NDC at billing width43742-2019Add 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
43742-2019-1	43742201901	30 mL in 1 BOTTLE, DROPPER (43742-2019-1)Marketed from Jun 18, 2021

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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): Leaky Gut Formula
Generic name (nonproprietary): alfalfa, glycyrrhiza glabra, astacus fluviatilis, berberis aquifolium, lac defloratum, natrum carbonicum, saccharum officinale, aloe, fel tauri, pancreas suis, pancreatinum, fragaria vesca, antimonium crudum, carbo vegetabilis, euphorbium officinarum, lycopodium clavatum, magnesia carbonica, zincum metallicum, colibacillinum cum natrum muriaticum, proteus (vulgaris)
Active ingredients: Medicago sativa whole — 3 [hp_X]/mLGlycyrrhiza glabra — 3 [hp_X]/mLAstacus astacus — 6 [hp_X]/mLBerberis aquifolium root bark — 6 [hp_X]/mLSkim milk — 6 [hp_X]/mLSodium carbonate — 6 [hp_X]/mLSucrose — 6 [hp_X]/mLAloe — 7 [hp_X]/mLBos taurus bile — 8 [hp_X]/mLSus scrofa pancreas — 8 [hp_X]/mLPancrelipase — 8 [hp_X]/mLFragaria vesca fruit — 9 [hp_X]/mLAntimony trisulfide — 12 [hp_X]/mLActivated charcoal — 12 [hp_X]/mLEuphorbia resinifera resin — 12 [hp_X]/mLLycopodium clavatum spore — 12 [hp_X]/mLMagnesium carbonate — 12 [hp_X]/mLZinc — 12 [hp_X]/mLEscherichia coli — 15 [hp_X]/mLProteus vulgaris — 15 [hp_X]/mL
Dosage form: Liquid
Route: Oral
Labeler: Deseret Biologicals, Inc.
Product type: Over-the-counter drug
Marketing category: Unapproved homeopathic
Marketing start: Jun 18, 2021
Marketing end: May 31, 2028
Other FDA classes: Allergens (Chemical structure)Cell-mediated Immunity (Physiologic effect)Dietary Proteins (Chemical structure)Increased Histamine Release (Physiologic effect)Plant Proteins (Chemical structure)
Identifiers: Product ID 43742-2019_eba4ef3d-e1b6-4c9b-a504-e58fa82f605aSPL ID eba4ef3d-e1b6-4c9b-a504-e58fa82f605aSPL set ID 8679e9ab-8610-47f1-be0e-66897f99881dUNII DJO934BRBD, 2788Z9758H, V0551986XQ, VZJ9F3C3SB, 6A001Y4M5A, 45P3261C7T, C151H8M554, V5VD430YW9, ET3651ZLOU, 9Y3J3362RY, FQ3DRG0N5K, CG6IX3GCMU, F79059A38U, 2P3VWU3H10, 1TI1O9028K, C88X29Y479, 0E53J927NA, J41CSQ7QDS, 514B9K0L10, 11T9HCO30O
Pharmacologic class: Non-Standardized Food Allergenic Extract; Non-Standardized Plant Allergenic Extract

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

N443742201901 followed by a unit qualifier and the quantity

Package 43742-2019-01. 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 Jul 14, 2023.

Indications (excerpt from the label)

HOMEOPATHIC INDICATIONS: For the temporary relief of symptoms related to leaky gut syndrome such as fatigue, seasonal allergies, joint pain, occasional constipation, mental fogginess and occasional diarrhea.** **These statements are based upon homeopathic principles. They have not been reviewed by the Food and Drug Administration.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)