Prescription drug · NDA
Leukotrap WB System (Cpda-1 blood bag collection system) NDC 87069-136
Dextrose monohydrate 2.23 g/70mL + 4 more ingredients · Solution · Intravenous · GVS TM INC
NDC codes
FDA NDC Directory| Package NDC | 11-digit (billing) | Package | Copy |
|---|---|---|---|
| 87069-136-64 | 8706901366487069013664 | 6 POUCH in 1 CARTON (87069-136-64) / 3 BAG in 1 POUCH / 70 mL in 1 BAGMarketed from Jun 24, 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)
- Leukotrap WB System
- Generic name (nonproprietary)
- cpda-1 blood bag collection system
- Active ingredients
- Dextrose monohydrate — 2.23 g/70mLAdenine — .019 g/70mLSodium citrate — 1.84 g/70mLCitric acid monohydrate — .229 g/70mLSodium phosphate, Monobasic, Monohydrate — .155 g/70mL
- Dosage form
- Solution
- Route
- Intravenous
- Labeler
- GVS TM INCNDC labeler code 87069
- Product type
- Prescription drug
- Marketing category
- NDA — New Drug ApplicationApplication BN 800077
- Marketing start
- Listing expires
- Other FDA classes
- Acidifying Activity (Mechanism)Acidifying Activity (Mechanism)Calcium Chelating Activity (Mechanism)Calcium Chelating Activity (Mechanism)Decreased Coagulation Factor Activity (Physiologic effect)Decreased Coagulation Factor Activity (Physiologic effect)
- Identifiers
- Product ID 87069-136_54fddca1-b40d-7af0-e063-6294a90a410eSPL ID 54fddca1-b40d-7af0-e063-6294a90a410eSPL set ID 54fddca1-b40c-7af0-e063-6294a90a410eUNII LX22YL083G, JAC85A2161, 1Q73Q2JULR, 2968PHW8QP, 593YOG76RN
- Pharmacologic class
- Anti-coagulant; Calculi Dissolution Agent
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.
- NDC on a medical claim
N487069013664followed by a unit qualifier and the quantityPackage 87069-0136-64. 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 .
About NDC 87069-136
- What is NDC 87069-136?
- 87069-136 is the product NDC for Leukotrap WB System (cpda-1 blood bag collection system), Dextrose monohydrate 2.23 g/70mL + 4 more ingredients solution, listed with the FDA by GVS TM INC. It has 1 package NDC, shown above in 10- and 11-digit form.
- What drug is associated with this NDC?
- Leukotrap WB System (CPDA-1 Blood Bag Collection System).
- What is the active ingredient?
- Dextrose monohydrate, Adenine, Sodium citrate, Citric acid monohydrate, Sodium phosphate, Monobasic, Monohydrate.
- Who is the labeler?
- GVS TM INC, NDC labeler code 87069. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
- What other NDCs exist for Leukotrap WB System?
- 1 other product NDC are listed under this name. See all Leukotrap WB System NDCs.
- Is there a related HCPCS / J-code?
- Not in Med-Code's curated HCPCS directory. See Billing references above.
Related NDCs: other Leukotrap WB System products
Other finished products listed under the same name: strengths, forms and labelers.
| Product | Strength | Form · route | Labeler | Product NDC | Package NDCs (11-digit) |
|---|---|---|---|---|---|
| Leukotrap WB Systemcpda-1 blood bag collection system | Dextrose monohydrate 2.01 g/63mL + 4 more ingredients | SolutionIntravenous | GVS TM INC | 87069-736 | 87069-0736-62 |
Other NDCs under BN 800077
Products listed under the same FDA application: other strengths and forms, and repackagers who relabel the same product.
| Product | Strength | Form · route | Labeler | Product NDC |
|---|---|---|---|---|
| Leukotrap WB Systemcpda-1 blood bag collection system | Dextrose monohydrate 2.01 g/63mL + 4 more ingredients | SolutionIntravenous | GVS TM INC | 87069-736 |