Theophylline NDC 31722-077

NDC codes

FDA NDC Directory

Product NDC (as listed)31722-077Labeler and product segments. Claims need a package NDC.

Product NDC at billing width31722-0077Add 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
31722-077-01	31722007701	100 TABLET, EXTENDED RELEASE in 1 BOTTLE (31722-077-01)Marketed from Sep 8, 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): Theophylline
Generic name (nonproprietary): theophylline
Active ingredients: Theophylline anhydrous — 300 mg/1
Dosage form: Tablet, Extended release
Route: Oral
Labeler: Camber Pharmaceuticals, Inc.
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 217422
Marketing start: Sep 8, 2023
Listing expires: Dec 31, 2026
Other FDA classes: Xanthines (Chemical structure)
Identifiers: Product ID 31722-077_05c7eb1d-0b79-ee46-e063-6294a90abfe4SPL ID 05c7eb1d-0b79-ee46-e063-6294a90abfe4SPL set ID bf320619-c53b-49a7-97b5-cd0c075a9f75RxCUI 314241, 317769UNII 0I55128JYK
Pharmacologic class: Methylxanthine

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

N431722007701 followed by a unit qualifier and the quantity

Package 31722-0077-01. 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 217422

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

FDA NDC Directory listings under ANDA 217422
Product	Strength	Form · route	Labeler	Product NDC
Theophylline	Theophylline anhydrous 450 mg/1	Tablet, Extended releaseOral	Camber Pharmaceuticals, Inc.	31722-078