NDC codes

FDA NDC Directory
Product NDC (as listed)76961-101Labeler and product segments. Claims need a package NDC.
Product NDC at billing width76961-0101Add 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
76961-101-0176961010101.6 mL in 1 SYRINGE, GLASS (76961-101-01)Marketed from Oct 18, 2022

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)
Rolvedon
Generic name (nonproprietary)
eflapegrastim-xnst
Active ingredients
Eflapegrastim13.2 mg/.6mL
Dosage form
Injection, Solution
Route
Subcutaneous
Product type
Prescription drug
Marketing category
BLA — Biologics License ApplicationApplication BLA 761148
Marketing start
Marketing end
Other FDA classes
Granulocyte Colony-Stimulating Factor (Chemical structure)Increased Myeloid Cell Production (Physiologic effect)
Identifiers
Product ID 76961-101_9209fc63-aee3-43dc-9bc6-16c5ed73d858SPL ID 9209fc63-aee3-43dc-9bc6-16c5ed73d858SPL set ID 6e436115-62e7-4729-aeb0-ff78ea685206RxCUI 2612541, 2612547UNII UT99UG9QJX
Pharmacologic class
Leukocyte Growth Factor

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

N476961010101 followed by a unit qualifier and the quantity

Package 76961-0101-01. 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

Current FDA label (SPL), effective .

Indications (excerpt from the label)

Rolvedon is indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in adult patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with clinically significant incidence of febrile neutropenia. Limitations of Use Rolvedon is not indicated for the mobilization of peripheral blood progenitor cells for hematopoietic stem cell transplantation. Rolvedon is a leukocyte growth factor indicated to decrease the incidence of infection, as manifested by febrile neutropenia, in adult patients with non-myeloid malignancies receiving myelosuppressive anti-cancer drugs associated with clinically significant incidence of febrile neutrop

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under BLA 761148

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

FDA NDC Directory listings under BLA 761148
ProductStrengthForm · routeLabelerProduct NDC
Rolvedoneflapegrastim-xnstEflapegrastim 13.2 mg/.6mLInjection, SolutionSubcutaneousAssertio Specialty Pharmaceuticals, LLC82497-132

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