NDC codes

FDA NDC Directory
Product NDC (as listed)65857-500Labeler and product segments. Claims need a package NDC.
Product NDC at billing width65857-0500Add 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
65857-500-206585705002020 VIAL in 1 CARTON (65857-500-20) / 5 mL in 1 VIALMarketed from Jun 1, 2010

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)
Kit for the Preparation of Technetium Tc99m Sestamibi
Generic name (nonproprietary)
kit for the preparation of technetium tc99m sestamibi
Active ingredients
Technetium tc-99m sestamibi — 1 mg/5mL
Dosage form
Injection, Powder, Lyophilized, For solution
Route
Parenteral
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 078809
Marketing start
Listing expires
Other FDA classes
Radiopharmaceutical Activity (Mechanism)
Identifiers
Product ID 65857-500_a5589464-e5bb-47b5-8a0c-372df1d7aed5SPL ID a5589464-e5bb-47b5-8a0c-372df1d7aed5SPL set ID 8626e756-767a-4a14-9188-658b58185254UNII 971Z4W1S09
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.

NDC on a medical claim

N465857050020 followed by a unit qualifier and the quantity

Package 65857-0500-20. 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)

Myocardial Imaging: Technetium Tc 99m Sestamibi Injection is a myocardial perfusion agent that is indicated for detecting coronary artery disease by localizing myocardial ischemia (reversible defects) and infarction (non-reversible defects), in evaluating myocardial function and developing information for use in patient management decisions. Technetium Tc 99m Sestamibi evaluation of myocardial ischemia can be accomplished with rest and cardiovascular stress techniques (e.g., exercise or pharmacologic stress in accordance with the pharmacologic stress agent’s labeling). It is usually not possible to determine the age of a myocardial infarction or to differentiate a recent myocardial infarctio…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Free account

Keep searching with a free account

You’ve used your 3 free searches for this session. Log in or create a free Med-Code account to keep looking up NDCs, J-codes and drugs.

Create a free accountLog in