NDC codes

FDA NDC Directory
Product NDC (as listed)42358-295Labeler and product segments. Claims need a package NDC.
Product NDC at billing width42358-0295Add 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
42358-295-01423580295011 VIAL, SINGLE-DOSE in 1 CARTON (42358-295-01) / 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL, SINGLE-DOSEMarketed from Oct 28, 2022

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)
Nulibry
Generic name (nonproprietary)
fosdenopterin hydrobromide
Active ingredients
Fosdenopterin hydrobromide — 9.5 mg/1
Dosage form
Injection, Powder, Lyophilized, For solution
Route
Intravenous
Labeler
Sentynl Therapeutics, Inc.NDC labeler code 42358
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 214018
Marketing start
Listing expires
Other FDA classes
Cyclic Pyranopterin Monophosphate (EXT)
Identifiers
Product ID 42358-295_cb790c3a-2ee7-4712-8e98-dc3748aad320SPL ID cb790c3a-2ee7-4712-8e98-dc3748aad320SPL set ID 736aeea3-f206-454d-95d0-fd30964e8aabRxCUI 2531292, 2531297UNII X41B5W735T
Pharmacologic class
Cyclic Pyranopterin Monophosphate

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

N442358029501 followed by a unit qualifier and the quantity

Package 42358-0295-01. 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 .

Indications (excerpt from the label)

NULIBRY is indicated to reduce the risk of mortality in patients with molybdenum cofactor deficiency (MoCD) Type A. NULIBRY is cyclic pyranopterin monophosphate (cPMP) indicated to reduce the risk of mortality in patients with molybdenum cofactor deficiency (MoCD) Type A. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 42358-295

What is NDC 42358-295?
42358-295 is the product NDC for Nulibry (fosdenopterin hydrobromide), Fosdenopterin hydrobromide 9.5 mg/1 injection, powder, lyophilized, for solution, listed with the FDA by Sentynl Therapeutics, Inc.. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Nulibry (Fosdenopterin hydrobromide).
What is the active ingredient?
Fosdenopterin hydrobromide.
Who is the labeler?
Sentynl Therapeutics, Inc., NDC labeler code 42358. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Nulibry?
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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