Prescription drug · ANDA

Rizatriptan Benzoate NDC 65862-626

Rizatriptan benzoate 10 mg/1 · Tablet, Orally disintegrating · Oral · Aurobindo Pharma Limited

NDC codes

FDA NDC Directory
Product NDC (as listed)65862-626Labeler and product segments. Claims need a package NDC.
Product NDC at billing width65862-0626Add 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
65862-626-12658620626124 BLISTER PACK in 1 CARTON (65862-626-12) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-626-03)Marketed from Jul 1, 2013
65862-626-18658620626183 BLISTER PACK in 1 CARTON (65862-626-18) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-626-06)Marketed from Jul 1, 2013
65862-626-36658620626369 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (65862-626-36)Marketed from Mar 5, 2018
65862-626-486586206264818 TABLET, ORALLY DISINTEGRATING in 1 BOTTLE (65862-626-48)Marketed from Mar 5, 2018
65862-626-64658620626641 BLISTER PACK in 1 CARTON (65862-626-64) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-626-03)Marketed from Aug 28, 2023
65862-626-90658620626903 BLISTER PACK in 1 CARTON (65862-626-90) / 3 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (65862-626-03)Marketed from Jul 1, 2013

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)
Rizatriptan Benzoate
Generic name (nonproprietary)
rizatriptan benzoate
Active ingredients
Rizatriptan benzoate — 10 mg/1
Dosage form
Tablet, Orally disintegrating
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 203062
Marketing start
Listing expires
Other FDA classes
Serotonin 1b Receptor Agonists (Mechanism)Serotonin 1d Receptor Agonists (Mechanism)
Identifiers
Product ID 65862-626_b813e372-4315-4a35-a6dd-592b69aee7b8SPL ID b813e372-4315-4a35-a6dd-592b69aee7b8SPL set ID a8e37688-426c-4290-933d-54a34ae86000RxCUI 312837, 312839UNII WR978S7QHHUPC 0365862625366
Pharmacologic class
Serotonin-1b and Serotonin-1d Receptor Agonist

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

N465862062612 followed by a unit qualifier and the quantity

Package 65862-0626-12. 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)

Rizatriptan benzoate orally disintegrating tablets are indicated for the acute treatment of migraine with or without aura in adults and in pediatric patients 6 to 17 years old. Limitations of Use Rizatriptan benzoate orally disintegrating tablets should only be used where a clear diagnosis of migraine has been established. If a patient has no response for the first migraine attack treated with rizatriptan benzoate orally disintegrating tablets, the diagnosis of migraine should be reconsidered before rizatriptan benzoate orally disintegrating tablets are administered to treat any subsequent attacks. Rizatriptan benzoate orally disintegrating tablets are not indicated for use in the management…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 203062

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

FDA NDC Directory listings under ANDA 203062
ProductStrengthForm · routeLabelerProduct NDC
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralBryant Ranch Prepack71335-1819
Rizatriptan BenzoateRizatriptan benzoate 5 mg/1Tablet, Orally disintegratingOralGolden State Medical Supply, Inc.51407-679
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralGolden State Medical Supply, Inc.51407-680
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralAdvanced Rx of Tennessee, LLC80425-0535
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralBryant Ranch Prepack71335-2982
Rizatriptan BenzoateRizatriptan benzoate 5 mg/1Tablet, Orally disintegratingOralRising Pharma Holdings, Inc.57237-085
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralRising Pharma Holdings, Inc.57237-086
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralREMEDYREPACK INC.70518-4362
Rizatriptan Benzoate ODTRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralDirect Rx72189-341
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralProficient Rx LP71205-557
Rizatriptan BenzoateRizatriptan benzoate 5 mg/1Tablet, Orally disintegratingOralAurobindo Pharma Limited65862-625
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralNuCare Pharmaceuticals,Inc.68071-3568
Rizatriptan BenzoateRizatriptan benzoate 10 mg/1Tablet, Orally disintegratingOralAsclemed USA, Inc.76420-909
Rizatriptan BenzoateRizatriptan benzoate 5 mg/1Tablet, Orally disintegratingOralAsclemed USA, Inc.76420-908

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