NDC 15054-0500-1 Dysport

Botulinum Toxin Type A

NDC Package Code 15054-0500-1

Field Name	Field Value
NDC Code	15054-0500-1
Package Description	1 VIAL in 1 CARTON > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL
Proprietary Name	Dysport What is the Proprietary Name? The proprietary name also known as the trade name is the name of the product chosen by the medication labeler for marketing purposes.
Non-Proprietary Name	Botulinum Toxin Type A What is the Non-Proprietary Name? The non-proprietary name is sometimes called the generic name. The generic name usually includes the active ingredient(s) of the product.
11-Digit NDC Billing Format	15054050001 NDC Format for Billing For insurance billing purposes the Centers for Medicare & Medicaid Services (CMS) created an 11 digit NDC derivative identifier. If the NDC Package code is less than 11 digits the code must be padded with leading zeros. The leading zeros must be added to the appropriate segment to create a 5-4-2 configuration.
Billing Unit	EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Product Type	Human Prescription Drug What kind of product is this? Indicates the type of product, such as Human Prescription Drug or Human Over the Counter Drug. This data element matches the “Document Type” field of the Structured Product Listing.
Labeler Name	Ipsen Biopharmaceuticals, Inc.
Dosage Form	Injection, Powder, Lyophilized, For Solution - A dosage form intended for the solution prepared by lyophilization ("freeze drying"), a process which involves the removal of water from products in the frozen state at extremely low pressures; this is intended for subsequent addition of liquid to create a solution that conforms in all respects to the requirements for Injections.
Administration Route(s)	Intramuscular - Administration within a muscle.
Active Ingredient(s)	BOTULINUM TOXIN TYPE A 500 U/1
Pharmacological Class(es)	Acetylcholine Release Inhibitor - [EPC] (Established Pharmacologic Class) Acetylcholine Release Inhibitors - [MoA] (Mechanism of Action)
Sample Package	No Sample Package? This field Indicates whether this package is a sample packaging or not.
Marketing Category	BLA - A product marketed under an approved Biologic License Application. What is the Marketing Category? Product types are broken down into several potential Marketing Categories, such as NDA/ANDA/BLA, OTC Monograph, or Unapproved Drug. One and only one Marketing Category may be chosen for a product, not all marketing categories are available to all product types. Currently, only final marketed product categories are included. The complete list of codes and translations can be found at www.fda.gov/edrls under Structured Product Labeling Resources.
FDA Application Number	BLA125274 What is the FDA Application Number? This corresponds to the NDA, ANDA, or BLA number reported by the labeler for products which have the corresponding Marketing Category designated. If the designated Marketing Category is OTC Monograph Final or OTC Monograph Not Final, then the Application number will be the CFR citation corresponding to the appropriate Monograph (e.g. “part 341”). For unapproved drugs, this field will be null.
Start Marketing Date	11-02-2009 What is the Start Marketing Date? This is the date that the labeler indicates was the start of its marketing of the drug product.
Listing Expiration Date	12-31-2020 What is the Listing Expiration Date? This is the date when the listing record will expire if not updated or certified by the product labeler.

The NDC Code 15054-0500-1 is assigned to Dysport, a human prescription drug labeled by Ipsen Biopharmaceuticals, Inc.. The product's dosage form is injection, powder, lyophilized, for solution and is administered via intramuscular form.

Code Structure

15054 - Ipsen Biopharmaceuticals, Inc.
- 15054-0500 - Dysport
  - 15054-0500-1 - 1 VIAL in 1 CARTON

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.

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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 15054-0500-1 HCPCS crosswalk information with package details and bill units information.

NDC Billing Code	HCPCS Code	HCPCS Code Desc.	Dosage	Package Size	Package Quantity	Billable Units	Billable Units / Pkg
15054050001	J0586	Abobotulinumtoxina	5 Unit	1	1	100	100

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Other Product Packages

The following packages are also available for Dysport with product NDC 15054-0500.

NDC Package Code	Package Description
15054-0500-2	2 VIAL in 1 CARTON > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL
15054-0500-9	1 VIAL in 1 CARTON > 1 INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION in 1 VIAL

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