Pemetrexed (pemetrexed disodium) NDC 67184-0504

NDC codes

FDA NDC Directory

Product NDC (as listed)67184-0504Labeler and product segments. Claims need a package NDC.

Product NDC at billing width67184-0504Add 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 NDC	11-digit (billing)	Package	Copy
67184-0504-1	67184050401	1 VIAL in 1 CARTON (67184-0504-1) / 20 mL in 1 VIALMarketed from May 25, 2022

How the 11-digit form is made: The package segment has 1 digit, so one leading zero is added to it (5-4-1 → 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): Pemetrexed
Generic name (nonproprietary): pemetrexed disodium
Active ingredients: Pemetrexed disodium hemipentahydrate — 500 mg/20mL
Dosage form: Injection, Powder, Lyophilized, For solution
Route: Intravenous
Labeler: Qilu Pharmaceutical Co., Ltd.
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 204890
Marketing start: May 25, 2022
Listing expires: Dec 31, 2026
Other FDA classes: Folic Acid Metabolism Inhibitors (Mechanism)
Identifiers: Product ID 67184-0504_0dc735ab-c4c9-4e19-bb80-8a439be7208cSPL ID 0dc735ab-c4c9-4e19-bb80-8a439be7208cSPL set ID 46a9b89d-7135-4e0c-b8e4-52580554769bRxCUI 1728072, 1728077UNII F4GSH45R4C
Pharmacologic class: Folate Analog Metabolic Inhibitor

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

N467184050401 followed by a unit qualifier and the quantity

Package 67184-0504-01. 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 Aug 13, 2021.

Indications (excerpt from the label)

Pemetrexed for Injection is a folate analog metabolic inhibitor indicated: in combination with pembrolizumab and platinum chemotherapy, for the initial treatment of patients with metastatic non-squamous NSCLC, with no EGFR or ALK genomic tumor aberrations. ( 1.1 ) in combination with cisplatin for the initial treatment of patients with locally advanced or metastatic, non-squamous, non-small cell lung cancer (NSCLC). ( 1.1 ) as a single agent for the maintenance treatment of patients with locally advanced or metastatic, non-squamous NSCLC whose disease has not progressed after four cycles of platinum-based first-line chemotherapy. ( 1.1 ) as a single agent for the treatment of patients with r…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 204890

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

FDA NDC Directory listings under ANDA 204890
Product	Strength	Form · route	Labeler	Product NDC
Pemetrexedpemetrexed disodium	Pemetrexed disodium hemipentahydrate 100 mg/4.2mL	Injection, Powder, Lyophilized, For solutionIntravenous	Sagent Pharmaceuticals	25021-260
Pemetrexedpemetrexed disodium	Pemetrexed disodium hemipentahydrate 500 mg/20mL	Injection, Powder, Lyophilized, For solutionIntravenous	Sagent Pharmaceuticals	25021-261
Pemetrexedpemetrexed disodium	Pemetrexed disodium hemipentahydrate 500 mg/20mL	Injection, Powder, Lyophilized, For solutionIntravenous	BluePoint Laboratories	68001-539
Pemetrexedpemetrexed disodium	Pemetrexed disodium hemipentahydrate 100 mg/4mL	Injection, Powder, Lyophilized, For solutionIntravenous	BluePoint Laboratories	68001-538
Pemetrexedpemetrexed disodium	Pemetrexed disodium hemipentahydrate 100 mg/4mL	Injection, Powder, Lyophilized, For solutionIntravenous	Qilu Pharmaceutical Co., Ltd.	67184-0503