Leukotrap WB System (cpda-1 blood bag collection system) NDC 87069-136

NDC codes

FDA NDC Directory

Product NDC (as listed)87069-136Labeler and product segments. Claims need a package NDC.

Product NDC at billing width87069-0136Add 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
87069-136-64	87069013664	6 POUCH in 1 CARTON (87069-136-64) / 3 BAG in 1 POUCH / 70 mL in 1 BAGMarketed from Jun 24, 2026

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): Leukotrap WB System
Generic name (nonproprietary): cpda-1 blood bag collection system
Active ingredients: Dextrose monohydrate — 2.23 g/70mLAdenine — .019 g/70mLSodium citrate — 1.84 g/70mLCitric acid monohydrate — .229 g/70mLSodium phosphate, Monobasic, Monohydrate — .155 g/70mL
Dosage form: Solution
Route: Intravenous
Labeler: GVS TM INC
Product type: Prescription drug
Marketing category: NDA — New Drug ApplicationApplication BN 800077
Marketing start: Jun 24, 2026
Listing expires: Dec 31, 2027
Other FDA classes: Acidifying Activity (Mechanism)Acidifying Activity (Mechanism)Calcium Chelating Activity (Mechanism)Calcium Chelating Activity (Mechanism)Decreased Coagulation Factor Activity (Physiologic effect)Decreased Coagulation Factor Activity (Physiologic effect)
Identifiers: Product ID 87069-136_54fddca1-b40d-7af0-e063-6294a90a410eSPL ID 54fddca1-b40d-7af0-e063-6294a90a410eSPL set ID 54fddca1-b40c-7af0-e063-6294a90a410eUNII LX22YL083G, JAC85A2161, 1Q73Q2JULR, 2968PHW8QP, 593YOG76RN
Pharmacologic class: Anti-coagulant; Calculi Dissolution Agent

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

N487069013664 followed by a unit qualifier and the quantity

Package 87069-0136-64. 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

Label details couldn’t be retrieved right now. Open the label on DailyMed.

Other NDCs under BN 800077

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

FDA NDC Directory listings under BN 800077
Product	Strength	Form · route	Labeler	Product NDC
Leukotrap WB Systemcpda-1 blood bag collection system	Dextrose monohydrate 2.01 g/63mL + 4 more ingredients	SolutionIntravenous	GVS TM INC	87069-736