NDC codes

FDA NDC Directory
Product NDC (as listed)25021-227Labeler and product segments. Claims need a package NDC.
Product NDC at billing width25021-0227Add 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
25021-227-062502102270610 VIAL in 1 CARTON (25021-227-06) / 6 mL in 1 VIALMarketed from Feb 15, 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)
Arsenic Trioxide
Generic name (nonproprietary)
arsenic trioxide
Active ingredients
Arsenic trioxide — 2 mg/mL
Dosage form
Injection
Route
Intravenous
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 215059
Marketing start
Listing expires
Identifiers
Product ID 25021-227_4c30347e-fd7f-418b-b85b-637b607c09fbSPL ID 4c30347e-fd7f-418b-b85b-637b607c09fbSPL set ID 7fe0fe9f-e87b-44ab-b92c-9b3d23942063RxCUI 829926, 1992545UNII S7V92P67HO

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

N425021022706 followed by a unit qualifier and the quantity

Package 25021-0227-06. 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)

Arsenic trioxide injection is an arsenical indicated: For induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression. ( 1.2 ) 1.2 Relapsed or Refractory APL Arsenic trioxide injection is indicated for induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 215059

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

FDA NDC Directory listings under ANDA 215059
ProductStrengthForm · routeLabelerProduct NDC
Arsenic TrioxideArsenic trioxide 1 mg/mLInjectionIntravenousGland Pharma Limited68083-535
Arsenic TrioxideArsenic trioxide 1 mg/mLInjectionIntravenousSagent Pharmaceuticals25021-226
Arsenic TrioxideArsenic trioxide 2 mg/mLInjectionIntravenousGland Pharma Limited68083-462
Arsenic TrioxideArsenic trioxide 1 mg/mLInjectionIntravenousHeritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Inc23155-869
Arsenic TrioxideArsenic trioxide 2 mg/mLInjectionIntravenousHeritage Pharma Labs Inc. d/b/a Avet Pharmaceuticals Inc23155-870

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