Rizatriptan Benzoate NDC 82804-202

NDC codes

FDA NDC Directory

Product NDC (as listed)82804-202Labeler and product segments. Claims need a package NDC.

Product NDC at billing width82804-0202Add 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
82804-202-12	82804020212	4 BLISTER PACK in 1 CARTON (82804-202-12) / 3 TABLET in 1 BLISTER PACKMarketed from Feb 25, 2025

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): Rizatriptan Benzoate
Generic name (nonproprietary): rizatriptan benzoate
Active ingredients: Rizatriptan benzoate — 10 mg/1
Dosage form: Tablet
Route: Oral
Labeler: Proficient Rx LP
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 202490
Marketing start: Dec 31, 2012
Listing expires: Dec 31, 2026
Other FDA classes: Serotonin 1b Receptor Agonists (Mechanism)Serotonin 1d Receptor Agonists (Mechanism)
Identifiers: Product ID 82804-202_e7414f2d-d7cf-41e5-b457-f5850e8bb7a7SPL ID e7414f2d-d7cf-41e5-b457-f5850e8bb7a7SPL set ID e7414f2d-d7cf-41e5-b457-f5850e8bb7a7RxCUI 314209UNII WR978S7QHHUPC 0382804202126
Pharmacologic class: Serotonin-1b and Serotonin-1d Receptor Agonist

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

N482804020212 followed by a unit qualifier and the quantity

Package 82804-0202-12. 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

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