NDC codes

FDA NDC Directory
Product NDC (as listed)83831-147Labeler and product segments. Claims need a package NDC.
Product NDC at billing width83831-0147Add 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
83831-147-05838310147051 VIAL, SINGLE-USE in 1 CARTON (83831-147-05) / 5 mL in 1 VIAL, SINGLE-USEMarketed from Mar 16, 2026

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)
Vykoura
Generic name (nonproprietary)
leucovorin calcium
Active ingredients
Leucovorin calcium — 50 mg/5mL
Dosage form
Injection
Route
Intramuscular, Intravenous
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 220406
Marketing start
Listing expires
Other FDA classes
Folic Acid (Chemical structure)
Identifiers
Product ID 83831-147_c655613e-4381-461e-8e2d-4121be761c04SPL ID c655613e-4381-461e-8e2d-4121be761c04SPL set ID d122b875-435e-4e00-b945-7a0546df95c2RxCUI 2104714, 2735355, 2735359, 2735364, 2735365, 2735366UNII RPR1R4C0P4UPC 0383831147053, 0383831148357, 0383831149507
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

N483831014705 followed by a unit qualifier and the quantity

Package 83831-0147-05. 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)

VYKOURA is indicated for: 1.1 Rescue after high-dose methotrexate (MTX) therapy in adult and pediatric patients. 1.2 Reducing the toxicity of: Methotrexate in adult and pediatric patients with impaired methotrexate elimination or Folic acid antagonists or dihydrofolate reductase (DHFR) inhibitors following an overdose in adult and pediatric patients. 1.3 Treatment of megaloblastic anemias due to folic acid deficiency in adult and pediatric patients when oral therapy is not feasible. 1.4 Treatment of patients with metastatic colorectal cancer in combination with fluorouracil. Limitations of Use VYKOURA is not indicated for pernicious anemia and megaloblastic anemia secondary to the lack of vi…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under NDA 220406

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

FDA NDC Directory listings under NDA 220406
ProductStrengthForm · routeLabelerProduct NDC
Vykouraleucovorin calciumLeucovorin calcium 350 mg/35mLInjectionIntramuscular, IntravenousAvyxa Pharma, LLC83831-148
Vykouraleucovorin calciumLeucovorin calcium 500 mg/50mLInjectionIntramuscular, IntravenousAvyxa Pharma, LLC83831-149

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