NDC codes

FDA NDC Directory
Product NDC (as listed)31722-808Labeler and product segments. Claims need a package NDC.
Product NDC at billing width31722-0808Add 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
31722-808-0231722080802200 TABLET in 1 BOTTLE (31722-808-02)Marketed from Sep 26, 2022
31722-808-323172208083210 BLISTER PACK in 1 CARTON (31722-808-32) / 10 TABLET in 1 BLISTER PACKMarketed from Sep 26, 2022
31722-808-603172208086060 TABLET in 1 BOTTLE (31722-808-60)Marketed from Sep 26, 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)
memantine hydrochloride
Generic name (nonproprietary)
memantine hydrochloride
Active ingredients
Memantine hydrochloride — 10 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 204389
Marketing start
Listing expires
Other FDA classes
NMDA Receptor Antagonists (Mechanism)
Identifiers
Product ID 31722-808_eabf0e61-425e-9c9f-e053-2a95a90ade8eSPL ID eabf0e61-425e-9c9f-e053-2a95a90ade8eSPL set ID 910827aa-5320-446c-8f66-3f17c0ee36d9RxCUI 996561, 996571UNII JY0WD0UA60UPC 0331722807609, 0331722808606
Pharmacologic class
N-methyl-D-aspartate Receptor Antagonist

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

N431722080802 followed by a unit qualifier and the quantity

Package 31722-0808-02. 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)

Memantine hydrochloride tablets are indicated for the treatment of moderate to severe dementia of the Alzheimer’s type. Memantine hydrochloride tablets are an N-methyl-D-aspartate (NMDA) receptor antagonist indicated for the treatment of moderate to severe dementia of the Alzheimer’s type. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 204389

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

FDA NDC Directory listings under ANDA 204389
ProductStrengthForm · routeLabelerProduct NDC
memantine hydrochlorideMemantine hydrochloride 5 mg/1TabletOralA-S Medication Solutions50090-7348
memantine hydrochlorideMemantine hydrochloride 10 mg/1TabletOralA-S Medication Solutions50090-7356
memantine hydrochlorideMemantine hydrochloride 5 mg/1TabletOralCamber Pharmaceuticals, Inc.31722-807

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