NDC codes

FDA NDC Directory
Product NDC (as listed)70121-1572Labeler and product segments. Claims need a package NDC.
Product NDC at billing width70121-1572Add 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
70121-1572-1701211572011 VIAL in 1 CARTON (70121-1572-1) / 17.5 mL in 1 VIALMarketed from Sep 8, 2017

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)
Levoleucovorin Calcium
Generic name (nonproprietary)
levoleucovorin
Active ingredients
Levoleucovorin calcium — 10 mg/mL
Dosage form
Injection, Solution
Route
Intravenous
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 207548
Marketing start
Listing expires
Other FDA classes
Folic Acid (Chemical structure)
Identifiers
Product ID 70121-1572_e396f53f-31ed-45be-a5ae-db217cdb6e86SPL ID e396f53f-31ed-45be-a5ae-db217cdb6e86SPL set ID 0c67eeae-3090-473d-b712-b9a83dc77b72RxCUI 1720765UNII 778XL6VBS8UPC 0370121157212
Pharmacologic class
Folate Analog

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

N470121157201 followed by a unit qualifier and the quantity

Package 70121-1572-01. 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)

Levoleucovorin injection is indicated for: rescue after high-dose methotrexate therapy in adult and pediatric patients with osteosarcoma. diminishing the toxicity associated with overdosage of folic acid antagonists or impaired methotrexate elimination in adult and pediatric patients. the treatment of adults with metastatic colorectal cancer in combination with fluorouracil. Limitations of Use Levoleucovorin injection is not indicated for pernicious anemia and megaloblastic anemia secondary to the lack of vitamin B 12 , because of the risk of progression of neurologic manifestations despite hematologic remission. Levoleucovorin injection is a folate analog indicated for: Rescue after high-do…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

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