NDC codes

FDA NDC Directory
Product NDC (as listed)63629-2169Labeler and product segments. Claims need a package NDC.
Product NDC at billing width63629-2169Add 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
63629-2169-163629216901100 CAPSULE in 1 BOTTLE (63629-2169-1)Marketed from Mar 11, 2021

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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)
dantrolene sodium
Generic name (nonproprietary)
dantrolene sodium
Active ingredients
Dantrolene sodium — 50 mg/1
Dosage form
Capsule
Route
Oral
Product type
Prescription drug
Marketing category
NDA authorized genericApplication NDA 017443
Marketing start
Listing expires
Other FDA classes
Decreased Striated Muscle Contraction (Physiologic effect)Decreased Striated Muscle Tone (Physiologic effect)
Identifiers
Product ID 63629-2169_0eb42fdc-2b82-4720-a7aa-24dbc4be869cSPL ID 0eb42fdc-2b82-4720-a7aa-24dbc4be869cSPL set ID db715aef-83ca-4608-befa-8288ab4adeeaRxCUI 856660UNII 287M0347EV
Pharmacologic class
Skeletal Muscle Relaxant

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

N463629216901 followed by a unit qualifier and the quantity

Package 63629-2169-01. 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

Current FDA label (SPL), effective . This label includes a boxed warning.

Indications (excerpt from the label)

INDICATIONS AND USAGE In Chronic Spasticity Dantrolene sodium is indicated in controlling the manifestations of clinical spasticity resulting from upper motor neuron disorders (e.g., spinal cord injury, stroke, cerebral palsy, or multiple sclerosis). It is of particular benefit to the patient whose functional rehabilitation has been retarded by the sequelae of spasticity. Such patients must have presumably reversible spasticity where relief of spasticity will aid in restoring residual function. Dantrolene sodium is not indicated in the treatment of skeletal muscle spasm resulting from rheumatic disorders. If improvement occurs, it will ordinarily occur within the dosage titration (see DOSAGE…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 017443

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

FDA NDC Directory listings under NDA 017443
ProductStrengthForm · routeLabelerProduct NDC
dantrolene sodiumDantrolene sodium 50 mg/1CapsuleOralREMEDYREPACK INC.70518-4668
dantrolene sodiumDantrolene sodium 25 mg/1CapsuleOralBryant Ranch Prepack63629-2168
dantrolene sodiumDantrolene sodium 25 mg/1CapsuleOralPar Health USA, LLC49884-362
dantrolene sodiumDantrolene sodium 50 mg/1CapsuleOralPar Health USA, LLC49884-363
dantrolene sodiumDantrolene sodium 100 mg/1CapsuleOralPar Health USA, LLC49884-364
dantrolene sodiumDantrolene sodium 25 mg/1CapsuleOralBryant Ranch Prepack72162-1497
Dantriumdantrolene sodiumDantrolene sodium 25 mg/1CapsuleOralPar Health USA, LLC42023-124
dantrolene sodiumDantrolene sodium 100 mg/1CapsuleOralREMEDYREPACK INC.70518-4622

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