Rabeprazole Sodium NDC 76420-107

NDC codes

FDA NDC Directory

Product NDC (as listed)76420-107Labeler and product segments. Claims need a package NDC.

Product NDC at billing width76420-0107Add 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
76420-107-30	76420010730	30 TABLET, DELAYED RELEASE in 1 BOTTLE (76420-107-30)Marketed from Jun 26, 2020
76420-107-60	76420010760	60 TABLET, DELAYED RELEASE in 1 BOTTLE (76420-107-60)Marketed from Jun 26, 2020
76420-107-90	76420010790	90 TABLET, DELAYED RELEASE in 1 BOTTLE (76420-107-90)Marketed from Jun 26, 2020

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): Rabeprazole Sodium
Generic name (nonproprietary): rabeprazole sodium
Active ingredients: Rabeprazole sodium — 20 mg/1
Dosage form: Tablet, Delayed release
Route: Oral
Labeler: Asclemed USA, Inc.
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 205761
Marketing start: Feb 17, 2017
Listing expires: Dec 31, 2026
Other FDA classes: Proton Pump Inhibitors (Mechanism)
Identifiers: Product ID 76420-107_a8f5a654-c183-044b-e053-2995a90af261SPL ID a8f5a654-c183-044b-e053-2995a90af261SPL set ID 12eaf996-db61-41d6-82e1-fa6196435603RxCUI 854868UNII 3L36P16U4R
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

N476420010730 followed by a unit qualifier and the quantity

Package 76420-0107-30. 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

Current FDA label (SPL), effective Jun 26, 2020.

Indications (excerpt from the label)

Rabeprazole sodium delayed-release tablets are a proton pump inhibitor (PPI) indicated in adults for: Healing of Erosive or Ulcerative Gastroesophageal Reflux Disease (GERD) ( 1.1 ). Maintenance of Healing of Erosive or Ulcerative GERD ( 1.2 ). Treatment of Symptomatic GERD ( 1.3 ). Healing of Duodenal Ulcers ( 1.4 ). Helicobacter pylori Eradication to Reduce Risk of Duodenal Ulcer Recurrence ( 1.5 ). Treatment of Pathological Hypersecretory Conditions, Including Zollinger-Ellison Syndrome ( 1.6 ). In adolescent patients 12 years of age and older for: Short-term Treatment of Symptomatic GERD ( 1.7 ). 1.1 Healing of Erosive or Ulcerative GERD in Adults Rabeprazole sodium delayed-release table…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 205761

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

FDA NDC Directory listings under ANDA 205761
Product	Strength	Form · route	Labeler	Product NDC
Rabeprazole Sodium	Rabeprazole sodium 20 mg/1	Tablet, Delayed releaseOral	DIRECT RX	72189-142
Rabeprazole Sodium	Rabeprazole sodium 20 mg/1	Tablet, Delayed releaseOral	Bryant Ranch Prepack	71335-1558
Rabeprazole Sodium	Rabeprazole sodium 20 mg/1	Tablet, Delayed releaseOral	Aurobindo Pharma Limited	65862-721