Dihydroergotamine mesylate NDC 72888-096

NDC codes

FDA NDC Directory

Product NDC (as listed)72888-096Labeler and product segments. Claims need a package NDC.

Product NDC at billing width72888-0096Add 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
72888-096-19	72888009619	8 KIT in 1 KIT (72888-096-19) / 1 VIAL, GLASS in 1 KIT (72888-096-18) / 1 mL in 1 VIAL, GLASSMarketed from Jun 23, 2023
72888-096-34	72888009634	1 VIAL, GLASS in 1 KIT (72888-096-34) / 1 mL in 1 VIAL, GLASSMarketed from Jun 23, 2023

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): Dihydroergotamine mesylate
Generic name (nonproprietary): dihydroergotamine mesylate
Active ingredients: Dihydroergotamine mesylate — 4 mg/mL
Dosage form: Spray
Route: Nasal
Labeler: Advagen Pharma Ltd
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 216881
Marketing start: Jun 23, 2023
Listing expires: Dec 31, 2027
Other FDA classes: Ergotamines (Chemical structure)
Identifiers: Product ID 72888-096_47c7c595-73f1-4f7c-e063-6394a90afd8fSPL ID 47c7c595-73f1-4f7c-e063-6394a90afd8fSPL set ID 65f8c60d-9213-48ac-8233-acc5d44548f4RxCUI 861668UNII 81AXN7R2QTUPC 0372888096346, 0372888096186
Pharmacologic class: Ergotamine Derivative

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. Nasal products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N472888009619 followed by a unit qualifier and the quantity

Package 72888-0096-19. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

Other NDCs under ANDA 216881

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

FDA NDC Directory listings under ANDA 216881
Product	Strength	Form · route	Labeler	Product NDC
Dihydroergotamine mesylate	Dihydroergotamine mesylate 4 mg/mL	SprayNasal	Trifluent Pharma, LLC	73352-096