NDC codes

FDA NDC Directory
Product NDC (as listed)65757-300Labeler and product segments. Claims need a package NDC.
Product NDC at billing width65757-0300Add 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
65757-300-01657570300011 KIT in 1 CARTON (65757-300-01) * 4 mL in 1 VIAL, GLASS (65757-302-02) * 4 mL in 1 VIAL, GLASS (65757-304-03)Marketed from Jun 13, 2006

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)
Vivitrol
Generic name (nonproprietary)
naltrexone
Dosage form
Kit
Labeler
Alkermes, Inc.NDC labeler code 65757
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 021897
Marketing start
Listing expires
Identifiers
Product ID 65757-300_59144e8d-9153-4f3c-8ae9-701137d4c7cdSPL ID 59144e8d-9153-4f3c-8ae9-701137d4c7cdSPL set ID cd11c435-b0f0-4bb9-ae78-60f101f3703fRxCUI 637213, 637216

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.

NDC on a medical claim

N465757030001 followed by a unit qualifier and the quantity

Package 65757-0300-01. 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)

Treatment with VIVITROL should be part of a comprehensive management program that includes psychosocial support. VIVITROL contains naltrexone, an opioid antagonist, and is indicated for the treatment of alcohol dependence in patients who are able to abstain from alcohol in an outpatient setting prior to initiation of treatment with VIVITROL. Patients should not be actively drinking at the time of initial VIVITROL administration ( 1.1 ). VIVITROL is indicated for the prevention of relapse to opioid dependence, following opioid detoxification ( 1.2 ). VIVITROL should be part of a comprehensive management program that includes psychosocial support ( 1 ). 1.1 Alcohol Dependence VIVITROL is indic…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

About NDC 65757-300

What is NDC 65757-300?
65757-300 is the product NDC for Vivitrol (naltrexone) kit, listed with the FDA by Alkermes, Inc.. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Vivitrol (Naltrexone).
Who is the labeler?
Alkermes, Inc., NDC labeler code 65757. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Vivitrol?
1 other product NDC are listed under this name. See all Vivitrol NDCs.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Vivitrol NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Vivitrolnaltrexone—KitAlkermes, Inc.65757-30165757-0301-01

Other NDCs under NDA 021897

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

FDA NDC Directory listings under NDA 021897
ProductStrengthForm · routeLabelerProduct NDC
Vivitrolnaltrexone—KitAlkermes, Inc.65757-301
Naltrexone—KitAmneal Pharmaceuticals NY LLC69238-2794

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