NDC codes

FDA NDC Directory
Product NDC (as listed)82804-136Labeler and product segments. Claims need a package NDC.
Product NDC at billing width82804-0136Add 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 NDC11-digit (billing)PackageCopy
82804-136-308280401363030 TABLET in 1 BOTTLE (82804-136-30)Marketed from Aug 28, 2024

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)
Methotrexate
Generic name (nonproprietary)
methotrexate
Active ingredients
Methotrexate sodium — 2.5 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 213343
Marketing start
Listing expires
Other FDA classes
Folic Acid Metabolism Inhibitors (Mechanism)
Identifiers
Product ID 82804-136_a76808f0-38a7-4b54-a4fb-3584f9058ae5SPL ID a76808f0-38a7-4b54-a4fb-3584f9058ae5SPL set ID a76808f0-38a7-4b54-a4fb-3584f9058ae5RxCUI 105585UNII 3IG1E710ZNUPC 0382804136308
Pharmacologic class
Folate Analog Metabolic 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

N482804013630 followed by a unit qualifier and the quantity

Package 82804-0136-30. 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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