Jolessa (levonorgestrel / ethinyl estradiol) NDC 0555-9123

NDC codes

FDA NDC Directory

Product NDC (as listed)0555-9123Labeler and product segments. Claims need a package NDC.

Product NDC at billing width00555-9123Add 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
0555-9123-66	00555912366	3 POUCH in 1 CARTON (0555-9123-66) / 1 BLISTER PACK in 1 POUCH / 1 KIT in 1 BLISTER PACKMarketed from Oct 13, 2003

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): Jolessa
Generic name (nonproprietary): levonorgestrel / ethinyl estradiol
Dosage form: Kit
Labeler: Teva Pharmaceuticals USA, Inc.
Product type: Prescription drug
Marketing category: NDA authorized genericApplication NDA 021544
Marketing start: Oct 13, 2003
Listing expires: Dec 31, 2027
Identifiers: Product ID 0555-9123_2b5bb263-c949-4464-b59a-49e78ba3d94cSPL ID 2b5bb263-c949-4464-b59a-49e78ba3d94c

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

N400555912366 followed by a unit qualifier and the quantity

Package 00555-9123-66. 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.