NDC codes

FDA NDC Directory
Product NDC (as listed)70121-1658Labeler and product segments. Claims need a package NDC.
Product NDC at billing width70121-1658Add 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
70121-1658-17012116580110 VIAL, SINGLE-DOSE in 1 CARTON (70121-1658-1) / 6 mL in 1 VIAL, SINGLE-DOSE (70121-1658-6)Marketed from Aug 20, 2021

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)
Arsenic Trioxide
Generic name (nonproprietary)
arsenic trioxide
Active ingredients
Arsenic trioxide — 2 mg/mL
Dosage form
Injection, Solution
Route
Intravenous
Product type
Prescription drug
Marketing category
ANDA — Abbreviated New Drug Application (generic)Application ANDA 210739
Marketing start
Listing expires
Identifiers
Product ID 70121-1658_773ddbdb-5a14-4f97-8db8-9a874d129153SPL ID 773ddbdb-5a14-4f97-8db8-9a874d129153SPL set ID 5845022e-8c01-451b-ae49-a28e58c5f845RxCUI 829926, 1992545UNII S7V92P67HOUPC 0370121165866

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

N470121165801 followed by a unit qualifier and the quantity

Package 70121-1658-01. 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 . This label includes a boxed warning.

Indications (excerpt from the label)

Arsenic trioxide injection is an arsenical indicated: For induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression. ( 1.2 ) 1.2 Relapsed or Refractory APL Arsenic trioxide injection is indicated for induction of remission and consolidation in patients with APL who are refractory to, or have relapsed from, retinoid and anthracycline chemotherapy, and whose APL is characterized by the presence of the t(15;17) translocation or PML/RAR-alpha gene expression.

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 210739

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

FDA NDC Directory listings under ANDA 210739
ProductStrengthForm · routeLabelerProduct NDC
Arsenic TrioxideArsenic trioxide 1 mg/mLInjection, SolutionIntravenousAmneal Pharmaceuticals LLC70121-1483

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