Rabeprazole Sodium Delayed-release
NDC Package 72834-210-30

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was inactivated by the FDA.

Rabeprazole Sodium Delayed-release is capsules are indicated for treatment of Gastroesophageal Reflux Disease (GERD) in pediatric patients 1 to 11 years of age for up to 12 weeks. Marketed by Sarras Health, Llc, this product is identified by NDC 72834-210 and is authorized under FDA application NDA204736.

Identification & Billing

NDC Package Code
72834-210-30
Package Description
30 CAPSULE, DELAYED RELEASE in 1 BOTTLE, PLASTIC
Product Code
72834-210
11-Digit Billing Format
72834021030
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
30 EA
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Rabeprazole Sodium Delayed-release
Dosage Form
-
Usage Information
Rabeprazole sodium delayed-release capsules are indicated for treatment of Gastroesophageal Reflux Disease (GERD) in pediatric patients 1 to 11 years of age for up to 12 weeks.

Regulatory & Marketing

Labeler Name
Sarras Health, Llc
FDA Application #
NDA204736
Marketing Category
NDA AUTHORIZED GENERIC - A product marketed as a "generic" drug under an approved New Drug Application (NDA), rather than an Abbreviated New Drug Application (ANDA),.
Start Marketing Date
06-27-2019
Listing Expiration
12-31-2021
Exclude Flag
I
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 72834-210-30 identifies a specific commercial package of 30 capsule, delayed release in 1 bottle, plastic of Rabeprazole Sodium Delayed-release, labeled by Sarras Health, Llc. This product is billed for "EA" each discreet unit and contains an estimated amount of 30 billable units per package. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Sarras Health, Llc on June 27, 2019. The current certification is valid through December 31, 2021.

How is this Sarras Health, Llc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72834021030. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 30 total billable units per package. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
72834-210-30
11-Digit CMS (5-4-2)
72834-0210-30

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.