Memantine Hydrochloride Tablet
NDC Package 72162-2003-5

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

Package Information

Memantine Hydrochloride tablets is classified as a

administered via oral route. This formulation utilizes a tablet delivery system. Marketed by Bryant Ranch Prepack, this product is identified by NDC 72162-2003 and is authorized under FDA application ANDA090961.

Identification & Billing

NDC Package Code
72162-2003-5
Package Description
500 TABLET in 1 BOTTLE
Product Code
72162-2003
11-Digit Billing Format
72162200305
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
500 EA
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Memantine Hydrochloride
Non-Proprietary Name
Memantine Hydrochloride
Substance Name
Memantine Hydrochloride
Dosage Form
Tablet - A solid dosage form containing medicinal substances with or without suitable diluents.
Administration Route
Oral - Administration to or by way of the mouth.
Active Ingredient(s)
MEMANTINE HYDROCHLORIDE 5 mg/1
Pharmacologic Class

Regulatory & Marketing

Labeler Name
Bryant Ranch Prepack
Product Type
Human Prescription Drug
FDA Application #
ANDA090961
Marketing Category
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date
02-28-2019
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (72162-2003). Click a package code to view its specific billing and regulatory data.

72162-2003-6
60 TABLET in 1 BOTTLE

* 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 72162-2003-5 identifies a specific commercial package of 500 tablet in 1 bottle of Memantine Hydrochloride, a human prescription drug labeled by Bryant Ranch Prepack. This product is billed for "EA" each discreet unit and contains an estimated amount of 500 billable units per package. This tablet is formulated for oral use and contains memantine hydrochloride 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 Bryant Ranch Prepack on February 28, 2019. The current certification is valid through December 31, 2026.

How is this Bryant Ranch Prepack product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72162200305. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 500 total billable units per package. 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 (5-4-1)
72162-2003-5
11-Digit CMS (5-4-2)
72162-2003-05

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