Cleviprex
NDC Package 10122-612-04

View Billable Units, 11-Digit Conversion Format, and RxNorm mappings
Table of Contents
    1. Package Information
    2. Frequently Asked Questions

Package Information

This product is EXCLUDED from the official NDC directory because the listing data was discontinued by the firm.

Cleviprex is a . Marketed by Chiesi Usa, Inc., this product is identified by NDC 10122-612 and is authorized under FDA application NDA022156.

Identification & Billing

NDC Package Code
10122-612-04
Package Description
4 CARTON in 1 CARTON / 1 VIAL, SINGLE-USE in 1 CARTON (10122-612-01) / 250 mL in 1 VIAL, SINGLE-USE
Product Code
10122-612
11-Digit Billing Format
10122061204

Clinical Specifications

Proprietary Name
Cleviprex
Dosage Form
-

Regulatory & Marketing

Labeler Name
Chiesi Usa, Inc.
FDA Application #
NDA022156
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
09-15-2008
End Marketing Date
09-29-2020
Listing Expiration
09-29-2020
Exclude Flag
D
Sample Package
No

Hierarchy Structure

Code Lineage

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 full disclaimer at the bottom of this page.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 10122-612-04 identifies a specific commercial package of 4 carton in 1 carton / 1 vial, single-use in 1 carton (10122-612-01) / 250 ml in 1 vial, single-use of Cleviprex, labeled by Chiesi Usa, Inc.. This is formulated for use and contains as the active substance.

Is this product currently listed with the FDA?

This product code is currently listed as inactive or excluded from the primary directory. It was introduced to the market by Chiesi Usa, Inc. on September 15, 2008. The current certification is valid through September 29, 2020.

How is this Chiesi Usa, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 10122061204. The table below illustrates the segment conversion from the 10-digit labeler code to the 11-digit provider format.

11-Digit Code Conversion

Billing payers usually require a 5-4-2 segment configuration. Below is the conversion from the 10-digit package format to the 11-digit billing format:

10-Digit Format (5-3-2)
10122-612-04
11-Digit CMS (5-4-2)
10122-0612-04

Note: The zero is added to the Product segment to maintain the 5-4-2 structure.