Membraneblue Injection, Solution
NDC Package 68803-672-05

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

Membraneblue (trypan blue) injection is membraneBlue™ 0.15% is indicated for use as an aid in ophthalmic surgery by staining the epiretinal membranes during ophthalmic surgical vitrectomy procedures, facilitating removal of the tissue. This formulation utilizes a injection, solution delivery system. Marketed by Dutch Ophthalmic Research Center (international) B.v., this product is identified by NDC 68803-672 and is authorized under FDA application NDA022278.

Identification & Billing

NDC Package Code
68803-672-05
Package Description
5 POUCH in 1 CARTON / 1 SYRINGE, GLASS in 1 POUCH / .5 mL in 1 SYRINGE, GLASS
Product Code
68803-672
11-Digit Billing Format
68803067205
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.

Clinical Specifications

Proprietary Name
Membraneblue
Non-Proprietary Name
Trypan Blue
Substance Name
Trypan Blue
Dosage Form
Injection, Solution - A liquid preparation containing one or more drug substances dissolved in a suitable solvent or mixture of mutually miscible solvents that is suitable for injection.
Administration Route
  • Intraocular - Administration within the eye.
  • Ophthalmic - Administration to the external eye.
Active Ingredient(s)
TRYPAN BLUE .75 mg/.5mL
Pharmacologic Class
Usage Information
MembraneBlue™ 0.15% is indicated for use as an aid in ophthalmic surgery by staining the epiretinal membranes during ophthalmic surgical vitrectomy procedures, facilitating removal of the tissue.

Regulatory & Marketing

Labeler Name
Dutch Ophthalmic Research Center (international) B.v.
Product Type
Human Prescription Drug
FDA Application #
NDA022278
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
02-20-2009
Listing Expiration
12-31-2026
Exclude Flag
N
Sample Package
No

Hierarchy Structure

Code Lineage

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 68803-672-05 identifies a specific commercial package of 5 pouch in 1 carton / 1 syringe, glass in 1 pouch / .5 ml in 1 syringe, glass of Membraneblue, a human prescription drug labeled by Dutch Ophthalmic Research Center (international) B.v.. This injection, solution is formulated for intraocular; ophthalmic use and contains trypan blue as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Dutch Ophthalmic Research Center (international) B.v. on February 20, 2009. The current certification is valid through December 31, 2026.

How is this Dutch Ophthalmic Research Center (international) B.v. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 68803067205. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
68803-672-05
11-Digit CMS (5-4-2)
68803-0672-05

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.