Trelstar (triptorelin pamoate) NDC 74676-5904

NDC codes

FDA NDC Directory

Product NDC (as listed)74676-5904Labeler and product segments. Claims need a package NDC.

Product NDC at billing width74676-5904Add 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
74676-5904-1	74676590401	1 KIT in 1 CARTON (74676-5904-1) * 2 mL in 1 VIAL, SINGLE-DOSE (74676-5904-0) * 2 mL in 1 SYRINGEMarketed from Jun 29, 2001

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): Trelstar
Generic name (nonproprietary): triptorelin pamoate
Dosage form: Kit
Labeler: Verity Pharmaceuticals Inc.
Product type: Prescription drug
Marketing category: NDA — New Drug ApplicationApplication NDA 021288
Marketing start: Jun 29, 2001
Listing expires: Dec 31, 2027
Identifiers: Product ID 74676-5904_ac43d5b2-3223-b955-2798-555d48497798SPL ID ac43d5b2-3223-b955-2798-555d48497798SPL set ID b1b84d62-a369-a4b7-5c41-dd1f553a18f3RxCUI 199821, 905053, 905057, 905059, 905062, 905064

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

N474676590401 followed by a unit qualifier and the quantity

Package 74676-5904-01. 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 Jun 30, 2026.

Indications (excerpt from the label)

TRELSTAR is indicated for the treatment of advanced prostate cancer [ see Clinical Studies (14) ]. TRELSTAR is a gonadotropin releasing hormone (GnRH) agonist indicated for the treatment of advanced prostate cancer. ( 1 )

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)