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  5. NDC Package Code: 0904-6621-04 Imatinib Mesylate

NDC Package 0904-6621-04 Imatinib Mesylate

Tablet, Film Coated Oral - View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. NDC HCPCS Crosswalk
    3. Frequently Asked Questions

Package Information

Find all the important details about this NDC Package code, including the 11-Digit NDC Billing number, billing units, wholesale price, RxNorm crosswalk, active ingredients, pharmacologic clasess, etc.

NDC Package Code:
0904-6621-04
Package Description:
30 BLISTER PACK in 1 CARTON / 1 TABLET, FILM COATED in 1 BLISTER PACK
Product Code:
0904-6621
Proprietary Name:
Imatinib Mesylate
Non-Proprietary Name:
Imatinib Mesylate
Substance Name:
Imatinib Mesylate
Usage Information:
This medication is used to treat certain types of cancer (such as acute lymphoblastic leukemia, chronic myeloid leukemia, gastrointestinal stromal tumors, and myelodysplastic/myeloproliferative diseases). It works by slowing or stopping the growth of cancer cells. Imatinib may also be used to treat certain immune system disorders (such as aggressive systemic mastocytosis, hypereosinophilic syndrome).
11-Digit NDC Billing Format:
00904662104
Billing Unit:
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
NDC to RxNorm Crosswalk:
30 EA
NDC to RxNorm Crosswalk:
Product Type:
Human Prescription Drug
Labeler Name:
Major Pharmaceuticals
Dosage Form:
Tablet, Film Coated - A solid dosage form that contains medicinal substances with or without suitable diluents and is coated with a thin layer of a water-insoluble or water-soluble polymer.
Administration Route(s):
Oral - Administration to or by way of the mouth.
Active Ingredient(s):
IMATINIB MESYLATE 400 mg/1
Pharmacologic Class(es):
Sample Package:
No
FDA Application Number:
ANDA079179
Marketing Category:
ANDA - A product marketed under an approved Abbreviated New Drug Application.
Start Marketing Date:
08-05-2016
Listing Expiration Date:
12-31-2026
Exclude Flag:
N
Code Structure:

The NDC Directory contains ONLY information on final marketed drugs submitted to FDA electronically by labelers. A labeler might be a manufacturer, re-packager or re-labeler. The product information included in the NDC directory does not indicate that FDA has verified the information provided by the product labeler. Assigned NDC numbers are not in any way an indication of FDA approval of the product.

* Please review the disclaimer below.

NDC HCPCS Crosswalk

This crosswalk is intended to help the public understand which drug products (identified by NDCs) are assigned to which HCPCS billing codes.

NDC 0904-6621-04 HCPCS crosswalk information with package details and bill units information.

NDC Billing CodeHCPCS CodeHCPCS Code Desc.DosagePackage SizePackage QuantityBillable UnitsBillable Units / Pkg
00904662104J8999PRESCRIPTION DRUG, ORAL, CHEMOTHERAPEUTIC, NOS1 EA30EA

* Please review the disclaimer below.

Frequently Asked Questions

What is NDC 0904-6621-04?

The NDC Packaged Code 0904-6621-04 is assigned to a package of 30 blister pack in 1 carton / 1 tablet, film coated in 1 blister pack of Imatinib Mesylate, a human prescription drug labeled by Major Pharmaceuticals. The product's dosage form is tablet, film coated and is administered via oral form.

Is NDC 0904-6621 included in the NDC Directory?

Yes, Imatinib Mesylate with product code 0904-6621 is active and included in the NDC Directory. The product was first marketed by Major Pharmaceuticals on August 05, 2016 and its listing in the NDC Directory is set to expire on December 31, 2026 if the product is not updated or renewed by the manufacturer.

What is the NDC billing unit for package 0904-6621-04?

The contents of this package are billed per "each", products billed on a per each basis are usually products dispensed in discreet units. The calculated billable units for this package is 30.

What is the 11-digit format for NDC 0904-6621-04?

The 11-digit format is 00904662104. The 11-digit billing format might be required by the Centers for Medicare & Medicaid Services (CMS) and other payers in billing claim forms.

This package code is originally configured in a 4-4-2 segment 10-digit format and by adding a zero within the original NDC package code we can obtain the converted 11-digit format in a 5-4-2 segment configuration. The table below shows the 11-digit code conversion:

10-Digit Format10-Digit Original Code11-Digit Format11-Digit Code
4-4-20904-6621-045-4-200904-6621-04