NDC codes

FDA NDC Directory
Product NDC (as listed)78206-131Labeler and product segments. Claims need a package NDC.
Product NDC at billing width78206-0131Add 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
78206-131-01782060131011 KIT in 1 CARTON (78206-131-01) / 1 CARTRIDGE in 1 KIT / 1.08 mL in 1 CARTRIDGE (78206-131-99)Marketed from Jul 24, 2023

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)
Follistim AQ
Generic name (nonproprietary)
follitropin
Active ingredients
Follitropin — 900 [iU]/1.08mL
Dosage form
Injection, Solution
Route
Subcutaneous
Product type
Prescription drug
Marketing category
BLA — Biologics License ApplicationApplication BLA 021211
Marketing start
Listing expires
Other FDA classes
Gonadotropins (Chemical structure)
Identifiers
Product ID 78206-131_1156138e-9093-46b4-aa5b-9b88e72d1790SPL ID 1156138e-9093-46b4-aa5b-9b88e72d1790SPL set ID 48489027-e52b-4b10-ae74-4ba03839150cRxCUI 854787, 854788, 854790, 1361563, 1361569, 1361572UNII 076WHW89TW
Pharmacologic class
Gonadotropin

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

N478206013101 followed by a unit qualifier and the quantity

Package 78206-0131-01. 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)

FOLLISTIM ® AQ Cartridge (follitropin beta) injection, is indicated: In Women for: FOLLISTIM AQ Cartridge is a gonadotropin indicated: In Women for: Induction of Ovulation and Pregnancy in Anovulatory Infertile Women in Whom the Cause of Infertility is Functional and Not Due to Primary Ovarian Failure ( 1.1 ) Pregnancy in Normal Ovulatory Women Undergoing Controlled Ovarian Stimulation as Part of an In Vitro Fertilization (IVF) or Intracytoplasmic Sperm Injection (ICSI) Cycle ( 1.2 ) In Men for: Induction of Spermatogenesis in Men with Primary and Secondary Hypogonadotropic Hypogonadism (HH) in Whom the Cause of Infertility is Not Due to Primary Testicular Failure ( 1.3 ) 1.1 Induction of Ov…

Excerpt only. Read the full label for complete information.

Full label on DailyMed (opens in a new tab)

Other NDCs under BLA 021211

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

FDA NDC Directory listings under BLA 021211
ProductStrengthForm · routeLabelerProduct NDC
Follistim AQfollitropinFollitropin 300 [iU]/.36mLInjection, SolutionSubcutaneousOrganon LLC78206-129
Follistim AQfollitropinFollitropin 600 [iU]/.72mLInjection, SolutionSubcutaneousOrganon LLC78206-130

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