NDC codes

FDA NDC Directory
Product NDC (as listed)72578-104Labeler and product segments. Claims need a package NDC.
Product NDC at billing width72578-0104Add 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
72578-104-84725780104845 BLISTER PACK in 1 CARTON (72578-104-84) / 6 TABLET, ORALLY DISINTEGRATING in 1 BLISTER PACK (72578-104-69)Marketed from Aug 7, 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)
Mirtazapine
Generic name (nonproprietary)
mirtazapine
Active ingredients
Mirtazapine — 30 mg/1
Dosage form
Tablet, Orally disintegrating
Route
Oral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 205798
Marketing start
Listing expires
Identifiers
Product ID 72578-104_9ad8f423-a877-4069-8a11-92e1f934974aSPL ID 9ad8f423-a877-4069-8a11-92e1f934974aSPL set ID ed491abe-9412-428b-8e24-57242862c99aRxCUI 283406, 283407, 283485UNII A051Q2099Q

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

N472578010484 followed by a unit qualifier and the quantity

Package 72578-0104-84. 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)

Mirtazapine orally disintegrating tablets are indicated for the treatment of major depressive disorder (MDD) in adults [see Clinical Studies (14) ] . Mirtazapine orally disintegrating tablets are indicated for the treatment of major depressive disorder (MDD) in adults. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 205798

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

FDA NDC Directory listings under ANDA 205798
ProductStrengthForm · routeLabelerProduct NDC
MirtazapineMirtazapine 15 mg/1Tablet, Orally disintegratingOralSQUARE PHARMACEUTICALS LIMITED76483-110
MirtazapineMirtazapine 30 mg/1Tablet, Orally disintegratingOralSQUARE PHARMACEUTICALS LIMITED76483-111
MirtazapineMirtazapine 45 mg/1Tablet, Orally disintegratingOralSQUARE PHARMACEUTICALS LIMITED76483-112
MirtazapineMirtazapine 45 mg/1Tablet, Orally disintegratingOralViona Pharmaceuticals Inc.72578-105
MirtazapineMirtazapine 15 mg/1Tablet, Orally disintegratingOralViona Pharmaceuticals Inc.72578-103
MirtazapineMirtazapine 30 mg/1Tablet, Orally disintegratingOralBryant Ranch Prepack71335-2471

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