NDC codes

FDA NDC Directory
Product NDC (as listed)63629-2374Labeler and product segments. Claims need a package NDC.
Product NDC at billing width63629-2374Add 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
63629-2374-163629237401100 TABLET in 1 BOTTLE (63629-2374-1)Marketed from Jul 4, 2018

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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)
Dextroamphetamine Sulfate
Generic name (nonproprietary)
dextroamphetamine sulfate
Active ingredients
Dextroamphetamine sulfate — 10 mg/1
Dosage form
Tablet
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 210059
Marketing start
Listing expires
DEA schedule
CII
Other FDA classes
Central Nervous System Stimulation (Physiologic effect)
Identifiers
Product ID 63629-2374_e950dc52-8c0d-4456-9481-773804c254d8SPL ID e950dc52-8c0d-4456-9481-773804c254d8SPL set ID 0ef920a9-c5b9-4d31-a478-ee18d22a3c5bRxCUI 884385UNII JJ768O327N

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

N463629237401 followed by a unit qualifier and the quantity

Package 63629-2374-01. 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 . This label includes a boxed warning.

Indications (excerpt from the label)

INDICATIONS AND USAGE Dextroamphetamine Sulfate Tablets USP are indicated for: Narcolepsy . Attention Deficit Disorder with Hyperactivity , as an integral part of a total treatment program which typically includes other remedial measures (psychological, educational, social) for a stabilizing effect in pediatric patients (ages 3 to 16 years) with a behavioral syndrome characterized by the following group of developmentally inappropriate symptoms: moderate to severe distractibility, short attention span, hyperactivity, emotional lability, and impulsivity. The diagnosis of this syndrome should not be made with finality when these symptoms are only of comparatively recent origin. Nonlocalizing (…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 210059

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

FDA NDC Directory listings under ANDA 210059
ProductStrengthForm · routeLabelerProduct NDC
Dextroamphetamine SulfateDextroamphetamine sulfate 10 mg/1TabletOralBryant Ranch Prepack72162-1234
Dextroamphetamine SulfateDextroamphetamine sulfate 5 mg/1TabletOralBryant Ranch Prepack72162-1233
Dextroamphetamine SulfateDextroamphetamine sulfate 10 mg/1TabletOralSUNRISE PHARMACEUTICAL, INC.11534-189
Dextroamphetamine SulfateDextroamphetamine sulfate 5 mg/1TabletOralBryant Ranch Prepack63629-2375
Dextroamphetamine SulfateDextroamphetamine sulfate 5 mg/1TabletOralSUNRISE PHARMACEUTICAL, INC.11534-188

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