NDC codes

FDA NDC Directory
Product NDC (as listed)65174-021Labeler and product segments. Claims need a package NDC.
Product NDC at billing width65174-0021Add 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
65174-021-10651740021101 INJECTION, SOLUTION in 1 CONTAINER (65174-021-10)Marketed from Sep 30, 2016

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)
Ruby-Fill
Generic name (nonproprietary)
rubidium rb 82
Active ingredients
Rubidium chloride rb-82 — 100 mCi/1
Dosage form
Injection, Solution
Route
Intravenous
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 202153
Marketing start
Listing expires
Other FDA classes
Radiopharmaceutical Activity (Mechanism)
Identifiers
Product ID 65174-021_efb00947-c7d1-4fc8-8ca0-24d80952b7efSPL ID efb00947-c7d1-4fc8-8ca0-24d80952b7efSPL set ID b3c0cc0c-2f4b-4e08-8a84-3cb77473c2e8UNII F0Z746KRKQ
Pharmacologic class
Radioactive Diagnostic 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

N465174002110 followed by a unit qualifier and the quantity

Package 65174-0021-10. 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)

RUBY-FILL is a closed system used to produce rubidium Rb 82 chloride injection for intravenous administration. Rubidium Rb 82 chloride injection is indicated for Positron Emission Tomography (PET) imaging of the myocardium under rest or pharmacologic stress conditions to evaluate regional myocardial perfusion in adult patients with suspected or existing coronary artery disease. RUBY-FILL is a closed system used to produce rubidium Rb 82 chloride injection for intravenous use. Rubidium Rb 82 chloride injection is a radioactive diagnostic agent indicated for Positron Emission Tomography (PET) imaging of the myocardium under rest or pharmacologic stress conditions to evaluate regional myocardia…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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