Phenytoin NDC 64980-573

NDC codes

FDA NDC Directory

Product NDC (as listed)64980-573Labeler and product segments. Claims need a package NDC.

Product NDC at billing width64980-0573Add 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
64980-573-01	64980057301	100 TABLET, CHEWABLE in 1 BOTTLE (64980-573-01)Marketed from May 3, 2024

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): Phenytoin
Generic name (nonproprietary): phenytoin
Active ingredients: Phenytoin — 50 mg/1
Dosage form: Tablet, Chewable
Route: Oral
Labeler: Rising Pharma Holdings, Inc.
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 200691
Marketing start: May 3, 2024
Listing expires: Dec 31, 2026
Other FDA classes: Cytochrome P450 1A2 Inducers (Mechanism)Cytochrome P450 2B6 Inducers (Mechanism)Cytochrome P450 2C19 Inducers (Mechanism)Cytochrome P450 2C8 Inducers (Mechanism)Cytochrome P450 2C9 Inducers (Mechanism)Cytochrome P450 2D6 Inducers (Mechanism)Cytochrome P450 3A Inducers (Mechanism)Decreased Central Nervous System Disorganized Electrical Activity (Physiologic effect)
Identifiers: Product ID 64980-573_14ec4c18-fa7a-46e6-ac18-a7c23253e51cSPL ID 14ec4c18-fa7a-46e6-ac18-a7c23253e51cSPL set ID e95cad66-b5f9-4802-a35f-fed340bf09abRxCUI 1313885UNII 6158TKW0C5
Pharmacologic class: Anti-epileptic Agent

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

N464980057301 followed by a unit qualifier and the quantity

Package 64980-0573-01. 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

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