Pulmozyme (dornase alfa) NDC 50242-100

NDC codes

FDA NDC Directory

Product NDC (as listed)50242-100Labeler and product segments. Claims need a package NDC.

Product NDC at billing width50242-0100Add 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	Copy
50242-100-40	50242010040	5 POUCH in 1 CARTON (50242-100-40) / 6 AMPULE in 1 POUCH (50242-100-39) / 2.5 mL in 1 AMPULEMarketed from Dec 30, 1993

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): Pulmozyme
Generic name (nonproprietary): dornase alfa
Active ingredients: Dornase alfa — 1 mg/mL
Dosage form: Solution
Route: Respiratory (Inhalation)
Labeler: Genentech, Inc.
Product type: Prescription drug
Marketing category: BLA — Biologics License ApplicationApplication BLA 103532
Marketing start: Dec 30, 1993
Listing expires: Dec 31, 2026
Other FDA classes: Decreased Respiratory Secretion Viscosity (Physiologic effect)Deoxyribonuclease I (Chemical structure)Recombinant Proteins (Chemical structure)
Identifiers: Product ID 50242-100_71192c41-f7be-44b0-b232-1f74369239a0SPL ID 71192c41-f7be-44b0-b232-1f74369239a0SPL set ID d8c78a7e-ff99-48f3-8952-643ec2ea0f86RxCUI 205532, 310014UNII 953A26OA1Y
Pharmacologic class: Recombinant Human Deoxyribonuclease 1

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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

NDC on a medical claim

N450242010040 followed by a unit qualifier and the quantity

Package 50242-0100-40. 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 Dec 17, 2025.

Indications (excerpt from the label)

PULMOZYME ® is indicated, in conjunction with standard therapies, for the management of pediatric and adult patients with cystic fibrosis (CF) to improve pulmonary function. In CF patients with an FVC ≥ 40% of predicted, daily administration of PULMOZYME has also been shown to reduce the risk of respiratory tract infections requiring parenteral antibiotics. PULMOZYME is a recombinant DNase enzyme indicated in conjunction with standard therapies for the management of cystic fibrosis (CF) patients to improve pulmonary function. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)