Voquezna Triple Pak Kit
NDC Package 81520-255-14

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

Package Information

Voquezna Triple Pak (vonoprazan fumarate, amoxicillin and clarithromycin) kits is vOQUEZNA TRIPLE PAK or VOQUEZNA DUAL PAK are indicated for the treatment of Helicobacter pylori (H. This formulation utilizes a kit delivery system. Marketed by Phathom Pharmaceuticals Inc., this product is identified by NDC 81520-255 and is authorized under FDA application NDA215152.

Identification & Billing

NDC Package Code
81520-255-14
Package Description
14 BLISTER PACK in 1 CARTON / 1 KIT in 1 BLISTER PACK (81520-255-01)
Product Code
81520-255
11-Digit Billing Format
81520025514
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
14 EA
RxNorm Crosswalk
  • RxCUI: 197517 - clarithromycin 500 MG Oral Tablet
  • RxCUI: 2604800 - vonoprazan 20 MG Oral Tablet
  • RxCUI: 2604800 - vonoprazan 20 MG (as vonoprazan fumarate 26.72 mg) Oral Tablet
  • RxCUI: 2604801 - {84 (amoxicillin 500 MG Oral Capsule) / 28 (vonoprazan 20 MG Oral Tablet) } Pack
  • RxCUI: 2604801 - amoxicillin 500 MG (84) / vonoprazan 20 MG (28) 14 Day DualPak Oral Pack

Clinical Specifications

Proprietary Name
Voquezna Triple Pak
Non-Proprietary Name
Vonoprazan Fumarate, Amoxicillin And Clarithromycin
Dosage Form
Kit - A packaged collection of related material.
Usage Information
VOQUEZNA TRIPLE PAK or VOQUEZNA DUAL PAK are indicated for the treatment of Helicobacter pylori (H. pylori) infection in adults [see Clinical Studies (14)].

Regulatory & Marketing

Labeler Name
Phathom Pharmaceuticals Inc.
Product Type
Human Prescription Drug
FDA Application #
NDA215152
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
11-08-2023
Listing Expiration
12-31-2026
Exclude Flag
N
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 81520-255-14 identifies a specific commercial package of 14 blister pack in 1 carton / 1 kit in 1 blister pack (81520-255-01) of Voquezna Triple Pak, a human prescription drug labeled by Phathom Pharmaceuticals Inc.. This kit is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Phathom Pharmaceuticals Inc. on November 08, 2023. The current certification is valid through December 31, 2026.

How is this Phathom Pharmaceuticals Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 81520025514. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 14 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)
81520-255-14
11-Digit CMS (5-4-2)
81520-0255-14

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