Prescription drug · NDA
Draximage Dtpa NDC 65174-288
kit for the preparation of technetium tc 99m pentetate · Pentetic acid 20 mg/1 · Injection, Powder, Lyophilized, For solution · Intravenous, Respiratory (Inhalation) · Jubilant DraxImage Inc., dba Jubilant Radiopharma
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 65174-288-30 | 65174028830 | 30 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 KIT (65174-288-30)Marketed from Dec 29, 1989 |
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)
- Draximage Dtpa
- Generic name (nonproprietary)
- kit for the preparation of technetium tc 99m pentetate
- Active ingredients
- Pentetic acid — 20 mg/1
- Dosage form
- Injection, Powder, Lyophilized, For solution
- Route
- Intravenous, Respiratory (Inhalation)
- Product type
- Prescription drug
- Marketing category
- NDA — New Drug ApplicationApplication NDA 018511
- Marketing start
- Listing expires
- Other FDA classes
- Lead Chelating Activity (Mechanism)
- Identifiers
- Product ID 65174-288_ea90e623-af26-4014-a0c3-3fe5d753a5e6SPL ID ea90e623-af26-4014-a0c3-3fe5d753a5e6SPL set ID becdab53-f7a7-7280-6930-21f3a61b99e7UNII 7A314HQM0I
- Pharmacologic class
- Lead Chelator
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.
- NDC on a medical claim
N465174028830followed by a unit qualifier and the quantityPackage 65174-0288-30. 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)
DRAXIMAGE ® DTPA, after radiolabeling with Technetium Tc 99m, is indicated for DRAXIMAGE ® DTPA is a kit for the preparation of Technetium Tc 99m pentetate injection. Technetium Tc 99m pentetate is a radioactive diagnostic agent indicated for: Brain imaging in adults ( 1.1 ). Renal visualization, assessment of renal perfusion, and estimation of glomerular filtration rate in adult and pediatric patients ( 1.2 ). Lung ventilation imaging and evaluation of pulmonary embolism when paired with perfusion imaging in adult and pediatric patients ( 1.3 ). 1.1 Brain Imaging Brain imaging in adults by intravenous administration. 1.2 Renal Scintigraphy Renal visualization, assessment of renal perfusion,…
Excerpt only. Read the full label for complete information.