Multrys (trace elements injection 4) NDC 0517-9302

NDC codes

FDA NDC Directory

Product NDC (as listed)0517-9302Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00517-9302Add 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
0517-9302-25	00517930225	25 VIAL, SINGLE-DOSE in 1 TRAY (0517-9302-25) / 1 mL in 1 VIAL, SINGLE-DOSE (0517-9302-01)Marketed from Sep 1, 2021

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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): Multrys
Generic name (nonproprietary): trace elements injection 4
Active ingredients: Zinc sulfate — 2470 ug/mLCupric sulfate — 150 ug/mLManganese sulfate — 8.22 ug/mLSelenious acid — 9.8 ug/mL
Dosage form: Injection, Solution
Route: Intravenous
Labeler: American Regent, Inc.
Product type: Prescription drug
Marketing category: NDA — New Drug ApplicationApplication NDA 209376
Marketing start: Sep 1, 2021
Listing expires: Dec 31, 2026
Other FDA classes: Decreased Copper Ion Absorption (Physiologic effect)Magnetic Resonance Contrast Activity (Mechanism)
Identifiers: Product ID 0517-9302_5c07b457-1143-440c-9975-90c16852a103SPL ID 5c07b457-1143-440c-9975-90c16852a103SPL set ID 995f1efa-aca0-4b6c-9099-f8e757c2133aRxCUI 2568573, 2568579UNII 89DS0H96TB, LRX7AJ16DT, W00LYS4T26, F6A27P4Q4RUPC 0305178201250
Pharmacologic class: Copper Absorption Inhibitor; Paramagnetic Contrast Agent

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.

Administration

Drug administration (CPT 96360–96549)

When a clinician administers the drug, the administration is reported separately. Codes in this range cover hydration, therapeutic injections and infusions, and chemotherapy or other complex drug administration. The right code depends on route, duration and drug type, and self-administered drugs are not billed this way.

How CPT relates to drug billing

NDC on a medical claim

N400517930225 followed by a unit qualifier and the quantity

Package 00517-9302-25. 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 Jul 1, 2024.

Indications (excerpt from the label)

Multrys is indicated in neonatal and pediatric patients weighing less than 10 kg as a source of zinc, copper, manganese, and selenium for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated. Multrys is a combination of trace elements (zinc sulfate, cupric sulfate, manganese sulfate, and selenious acid) indicated in neonatal and pediatric patients weighing less than 10 kg as a source of zinc, copper, manganese, and selenium for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 209376

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

FDA NDC Directory listings under NDA 209376
Product	Strength	Form · route	Labeler	Product NDC
Tralementtrace elements injection 4	Zinc sulfate 3 mg/mL + 3 more ingredients	Injection, SolutionIntravenous	American Regent, Inc.	0517-9305