NDC codes

FDA NDC Directory
Product NDC (as listed)0069-0502Labeler and product segments. Claims need a package NDC.
Product NDC at billing width00069-0502Add 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
0069-0502-30000690502300006905023030 TABLET, FILM COATED, EXTENDED RELEASE in 1 BOTTLE (0069-0502-30)Marketed from Jan 21, 2020

How the 11-digit form is made: The labeler segment has 4 digits, so one leading zero is added to it (4-4-2 → 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)
Xeljanz XRSuffix: XR
Generic name (nonproprietary)
tofacitinib
Active ingredients
Tofacitinib citrate — 22 mg/1
Dosage form
Tablet, Film coated, Extended release
Route
Oral
Labeler
Pfizer Laboratories Div Pfizer IncNDC labeler code 0069
Product type
Prescription drug
Marketing category
NDA — New Drug ApplicationApplication NDA 208246
Marketing start
Listing expires
Other FDA classes
Janus Kinase Inhibitors (Mechanism)
Identifiers
Product ID 0069-0502_23ff09f3-4af4-4232-a8b3-d84f8f16fb9cSPL ID 23ff09f3-4af4-4232-a8b3-d84f8f16fb9c
Pharmacologic class
Janus Kinase Inhibitor

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 HCPCS code in Med-Code's directory. Oral products like this are usually dispensed by a pharmacy and billed by NDC.

NDC on a medical claim

N400069050230 followed by a unit qualifier and the quantity

Package 00069-0502-30. 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

The FDA listing for this product does not reference a label (SPL) set.

About NDC 0069-0502

What is NDC 0069-0502?
0069-0502 is the product NDC for Xeljanz XR (tofacitinib), Tofacitinib citrate 22 mg/1 tablet, film coated, extended release, listed with the FDA by Pfizer Laboratories Div Pfizer Inc. It has 1 package NDC, shown above in 10- and 11-digit form.
What drug is associated with this NDC?
Xeljanz XR (Tofacitinib).
What is the active ingredient?
Tofacitinib citrate.
Who is the labeler?
Pfizer Laboratories Div Pfizer Inc, NDC labeler code 0069. The labeler is the company responsible for the label; it may be the manufacturer, a repackager or a distributor.
What other NDCs exist for Xeljanz XR?
3 other product NDCs are listed under this name. See all Xeljanz XR NDCs.
Is there a related HCPCS / J-code?
Not in Med-Code's curated HCPCS directory. See Billing references above.

Other finished products listed under the same name: strengths, forms and labelers.

Other Xeljanz XR NDCs
ProductStrengthForm · routeLabelerProduct NDCPackage NDCs (11-digit)
Xeljanz XRtofacitinibTofacitinib citrate 22 mg/1Tablet, Extended releaseOralU.S. Pharmaceuticals63539-50263539-0502-30
Xeljanz XRtofacitinibTofacitinib citrate 11 mg/1Tablet, Film coated, Extended releaseOralPfizer Laboratories Div Pfizer Inc0069-050100069-0501-30
Xeljanz XRtofacitinibTofacitinib citrate 11 mg/1Tablet, Extended releaseOralU.S. Pharmaceuticals63539-50163539-0501-30

Other NDCs under NDA 208246

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

FDA NDC Directory listings under NDA 208246
ProductStrengthForm · routeLabelerProduct NDC
Xeljanz XRtofacitinibTofacitinib citrate 11 mg/1Tablet, Film coated, Extended releaseOralPfizer Laboratories Div Pfizer Inc0069-0501
Xeljanz XRtofacitinibTofacitinib citrate 11 mg/1Tablet, Extended releaseOralU.S. Pharmaceuticals63539-501
Xeljanz XRtofacitinibTofacitinib citrate 22 mg/1Tablet, Extended releaseOralU.S. Pharmaceuticals63539-502

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