NDC codes

FDA NDC Directory
Product NDC (as listed)68803-672Labeler and product segments. Claims need a package NDC.
Product NDC at billing width68803-0672Add 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
68803-672-05688030672055 POUCH in 1 CARTON (68803-672-05) / 1 SYRINGE, GLASS in 1 POUCH / .5 mL in 1 SYRINGE, GLASSMarketed from Feb 20, 2009

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)
Membraneblue
Generic name (nonproprietary)
trypan blue
Active ingredients
Trypan blue — .75 mg/.5mL
Dosage form
Injection, Solution
Route
Intraocular, Ophthalmic
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 022278
Marketing start
Listing expires
Other FDA classes
Dyes (Mechanism)
Identifiers
Product ID 68803-672_44559f09-e0e2-a332-e063-6394a90aa296SPL ID 44559f09-e0e2-a332-e063-6394a90aa296SPL set ID 0364aceb-dd3f-4bac-b468-25379a07ccfcUNII I2ZWO3LS3M
Pharmacologic class
Diagnostic Dye

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 drug-specific HCPCS code in Med-Code's directory for this product. The directory is curated and not complete — check the current CMS HCPCS file before billing.

NDC on a medical claim

N468803067205 followed by a unit qualifier and the quantity

Package 68803-0672-05. 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 .

Indications (excerpt from the label)

MembraneBlue 0.15% - Indications & Usage Section 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 in adults and pediatric patients. These highlights do not include all the information needed to use MEMBRANEBLUE™ safely and effectively. See full prescribing information for MEMBRANEBLUE. MEMBRANEBLUE (trypan blue ophthalmic solution) 0.15%, for intraocular ophthalmic use Initial U.S. Approval: 2004 MembraneBlue is a diagnostic dye indicated for use as an aid in ophthalmic posterior surgery by staining the epiretinal membranes during ophthalmic surgic…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 68803-672

What is NDC 68803-672?
68803-672 is the product NDC for Membraneblue (trypan blue), Trypan blue .75 mg/.5mL injection, solution, listed with the FDA by Dutch Ophthalmic Research Center (International) B.V.. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Membraneblue (Trypan blue).
What is the active ingredient?
Trypan blue.
Who is the labeler?
Dutch Ophthalmic Research Center (International) B.V., NDC labeler code 68803. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Membraneblue?
None: this is the only finished product listed under this name.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

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