Folotyn (pralatrexate) NDC 72893-005

NDC codes

FDA NDC Directory

Product NDC (as listed)72893-005Labeler and product segments. Claims need a package NDC.

Product NDC at billing width72893-0005Add 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
72893-005-01	72893000501	1 VIAL in 1 CARTON (72893-005-01) / 2 mL in 1 VIALMarketed from Sep 24, 2009

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): Folotyn
Generic name (nonproprietary): pralatrexate
Active ingredients: Pralatrexate — 40 mg/2mL
Dosage form: Injection
Route: Intravenous
Labeler: Acrotech Biopharma Inc
Product type: Prescription drug
Marketing category: NDA — New Drug ApplicationApplication NDA 022468
Marketing start: Sep 24, 2009
Listing expires: Dec 31, 2027
Identifiers: Product ID 72893-005_a10f6330-f643-4d2b-b4b0-541d5e8ec387SPL ID a10f6330-f643-4d2b-b4b0-541d5e8ec387
Pharmacologic class: Folate Analog Metabolic 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 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

N472893000501 followed by a unit qualifier and the quantity

Package 72893-0005-01. 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 NDA 022468

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

FDA NDC Directory listings under NDA 022468
Product	Strength	Form · route	Labeler	Product NDC
Folotynpralatrexate	Pralatrexate 20 mg/mL	InjectionIntravenous	Acrotech Biopharma Inc	72893-003
Pralatrexate	Pralatrexate 20 mg/mL	InjectionIntravenous	Fresenius Kabi USA, LLC	65219-550
Pralatrexate	Pralatrexate 40 mg/2mL	InjectionIntravenous	Fresenius Kabi USA, LLC	65219-552