NDC codes

FDA NDC Directory
Product NDC (as listed)72789-246Labeler and product segments. Claims need a package NDC.
Product NDC at billing width72789-0246Add 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
72789-246-9872789024698120 TABLET, DELAYED RELEASE in 1 BOTTLE, PLASTIC (72789-246-98)Marketed from Apr 19, 2022

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)
mycophenolic acid
Generic name (nonproprietary)
mycophenolic acid
Active ingredients
Mycophenolate sodium — 360 mg/1
Dosage form
Tablet, Delayed release
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 214289
Marketing start
Marketing end
Identifiers
Product ID 72789-246_563043e6-9810-d572-e063-6294a90a086cSPL ID 563043e6-9810-d572-e063-6294a90a086cSPL set ID bc38bc5e-7f0a-4419-81ec-04726ce47421RxCUI 485020, 485023UNII WX877SQI1GUPC 0372789246987, 0372789247984
Pharmacologic class
Antimetabolite Immunosuppressant

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

N472789024698 followed by a unit qualifier and the quantity

Package 72789-0246-98. 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 .

Indications (excerpt from the label)

Mycophenolic acid delayed-release tablets are an antimetabolite immunosuppressant indicated for prophylaxis of organ rejection in adult patients receiving kidney transplants and in pediatric patients at least 5 years of age and older who are at least 6 months post kidney transplant. ( 1.1 ) Use in combination with cyclosporine and corticosteroids. ( 1.1 ) Limitations of Use: Mycophenolic acid delayed release tablets and mycophenolate mofetil tablets and capsules should not be used interchangeably. ( 1.2 ) 1.1 Prophylaxis of Organ Rejection in Kidney Transplant Mycophenolic acid delayed-release tablets are indicated for the prophylaxis of organ rejection in adult patients receiving a kidney t…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 214289

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

FDA NDC Directory listings under ANDA 214289
ProductStrengthForm · routeLabelerProduct NDC
mycophenolic acidMycophenolate sodium 180 mg/1Tablet, Delayed releaseOralPD-Rx Pharmaceuticals, Inc.72789-247
mycophenolic acidMycophenolate sodium 180 mg/1Tablet, Delayed releaseOralUpsher-Smith Laboratories, LLC24979-160
mycophenolic acidMycophenolate sodium 360 mg/1Tablet, Delayed releaseOralUpsher-Smith Laboratories, LLC24979-161

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