Tri-Lo- Estarylla NDC 70700-120

NDC codes

FDA NDC Directory

Product NDC (as listed)70700-120Labeler and product segments. Claims need a package NDC.

Product NDC at billing width70700-0120Add 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
70700-120-85	70700012085	3 BLISTER PACK in 1 CARTON (70700-120-85) / 1 KIT in 1 BLISTER PACKMarketed from Feb 10, 2023

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): Tri-Lo- Estarylla
Generic name (nonproprietary): norgestimate and ethinyl estradiol
Dosage form: Kit
Labeler: Xiromed, LLC.
Product type: Prescription drug
Marketing category: ANDA — Abbreviated New Drug Application (generic)Application ANDA 091232
Marketing start: Jan 1, 2018
Listing expires: Dec 31, 2026
Identifiers: Product ID 70700-120_b2a112e8-a8c4-2254-1046-9ee6263e66e1SPL ID b2a112e8-a8c4-2254-1046-9ee6263e66e1SPL set ID 8381db98-f9b2-e894-c07e-5d49f10e4eeaRxCUI 578732, 748797, 749155, 749156, 749157, 1722676

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

N470700012085 followed by a unit qualifier and the quantity

Package 70700-0120-85. 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 Dec 21, 2023. This label includes a boxed warning.

Indications (excerpt from the label)

Tri-Lo-Estarylla (norgestimate and ethinyl estradiol tablets) is an estrogen/progestin COC, indicated for use by women to prevent pregnancy. ( 1.1 ) 1.1 Oral Contraception Tri-Lo-Estarylla (norgestimate and ethinyl estradiol tablets) are indicated for use by females of reproductive potential to prevent pregnancy [see CLINICAL STUDIES (14) ].

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under ANDA 091232

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

FDA NDC Directory listings under ANDA 091232
Product	Strength	Form · route	Labeler	Product NDC
Tri-Lo- Estaryllanorgestimate and ethinyl estradiol	—	Kit	Bryant Ranch Prepack	63629-2351
Norgestimate and Ethinyl Estradiol	—	Kit	AvKARE	42291-565