Esomeprazole magnesium NDC 67877-571

NDC codes

FDA NDC Directory

Product NDC (as listed)67877-571Labeler and product segments. Claims need a package NDC.

Product NDC at billing width67877-0571Add 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
67877-571-05	67877057105	500 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-571-05)Marketed from Feb 27, 2021
67877-571-10	67877057110	1000 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-571-10)Marketed from Feb 27, 2021
67877-571-30	67877057130	30 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-571-30)Marketed from Feb 27, 2021
67877-571-38	67877057138	10 BLISTER PACK in 1 CARTON (67877-571-38) / 10 CAPSULE, COATED PELLETS in 1 BLISTER PACKMarketed from Feb 27, 2021
67877-571-90	67877057190	90 CAPSULE, COATED PELLETS in 1 BOTTLE (67877-571-90)Marketed from Feb 27, 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): Esomeprazole magnesium
Generic name (nonproprietary): esomeprazole magnesium delayed release capsules
Active ingredients: Esomeprazole magnesium — 20 mg/1
Dosage form: Capsule, Coated pellets
Route: Oral
Labeler: Ascend Laboratories, LLC
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 210559
Marketing start: Feb 27, 2021
Listing expires: Dec 31, 2026
Other FDA classes: Cytochrome P450 2C19 Inhibitors (Mechanism)Proton Pump Inhibitors (Mechanism)
Identifiers: Product ID 67877-571_27b22eed-c148-41cd-bdd7-434610f98b70SPL ID 27b22eed-c148-41cd-bdd7-434610f98b70SPL set ID 277ce748-2809-4be0-81e7-6a4d604f2c6fRxCUI 606726, 606730UNII R6DXU4WAY9UPC 0367877571300
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

N467877057105 followed by a unit qualifier and the quantity

Package 67877-0571-05. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

Other NDCs under ANDA 210559

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

FDA NDC Directory listings under ANDA 210559
Product	Strength	Form · route	Labeler	Product NDC
Esomeprazole magnesiumesomeprazole magnesium delayed release capsules	Esomeprazole magnesium 40 mg/1	Capsule, Coated pelletsOral	Asclemed USA, Inc.	76420-227
Esomeprazole magnesiumesomeprazole magnesium delayed release capsules	Esomeprazole magnesium 20 mg/1	Capsule, Coated pelletsOral	Asclemed USA, Inc.	76420-226
Esomeprazole magnesiumesomeprazole magnesium delayed release capsules	Esomeprazole magnesium trihydrate 20 mg/1	Capsule, Coated pelletsOral	Proficient Rx LP	71205-706
Esomeprazole magnesiumesomeprazole magnesium delayed release capsules	Esomeprazole magnesium 40 mg/1	Capsule, Coated pelletsOral	Ascend Laboratories, LLC	67877-572
Esomeprazole magnesiumesomeprazole magnesium delayed release capsules	Esomeprazole magnesium 20 mg/1	Capsule, Coated pelletsOral	Bryant Ranch Prepack	71335-9678