Alprolix NDC 71104-922

NDC codes

FDA NDC Directory

Product NDC (as listed)71104-922Labeler and product segments. Claims need a package NDC.

Product NDC at billing width71104-0922Add 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
71104-922-01	71104092201	1 KIT in 1 KIT (71104-922-01) * 5 mL in 1 VIAL (71104-954-09) * 5 mL in 1 VIAL (71104-045-01)Marketed from May 5, 2014

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): Alprolix
Generic name (nonproprietary): coagulation factor ix (recombinant), fc fusion protein
Dosage form: Kit
Labeler: Bioverativ Therapeutics Inc.
Product type: Plasma derivative
Marketing category: BLA — Biologics License ApplicationApplication BLA 125444
Marketing start: May 5, 2014
Listing expires: Dec 31, 2026
Identifiers: Product ID 71104-922_24887518-9870-451a-9db5-b03dc5571c19SPL ID 24887518-9870-451a-9db5-b03dc5571c19

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

N471104092201 followed by a unit qualifier and the quantity

Package 71104-0922-01. 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

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

Other NDCs under BLA 125444

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

FDA NDC Directory listings under BLA 125444
Product	Strength	Form · route	Labeler	Product NDC
Alprolixcoagulation factor ix (recombinant), fc fusion protein	—	Kit	Bioverativ Therapeutics Inc.	71104-911
Alprolixcoagulation factor ix (recombinant), fc fusion protein	—	Kit	Bioverativ Therapeutics Inc.	71104-977
Alprolixcoagulation factor ix (recombinant), fc fusion protein	—	Kit	Bioverativ Therapeutics Inc.	71104-933
Alprolixcoagulation factor ix (recombinant), fc fusion protein	—	Kit	Bioverativ Therapeutics Inc.	71104-944
Alprolixcoagulation factor ix (recombinant), fc fusion protein	—	Kit	Bioverativ Therapeutics Inc.	71104-966