NDC 61953-0005-2 Flebogamma Dif

Immune Globulin Intravenous (human)

NDC Package Code 61953-0005-2

The NDC Code 61953-0005-2 is assigned to a package of 1 vial in 1 carton > 100 ml in 1 vial (61953-0005-5) of Flebogamma Dif, a plasma derivative labeled by Grifols Usa, Llc. The product's dosage form is injection, solution and is administered via intravenous form.

Field Name	Field Value
NDC Code	61953-0005-2
Package Description	1 VIAL in 1 CARTON > 100 mL in 1 VIAL (61953-0005-5)
Proprietary Name	Flebogamma Dif 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	Immune Globulin Intravenous (human) 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	61953000502 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	ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
Product Type	Plasma Derivative 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	Grifols Usa, Llc
Dosage Form	Injection, Solution - A liquid preparation containing one or more drug substances dissolved in a suitable solvent or mixture of mutually miscible solvents that is suitable for injection.
Administration Route(s)	Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)	HUMAN IMMUNOGLOBULIN G 5 g/50mL
Pharmacological Class(es)	Human Immunoglobulin G - [EPC] (Established Pharmacologic Class) Passively Acquired Immunity - [PE] (Physiologic Effect) Antigen Neutralization - [MoA] (Mechanism of Action) Immunoglobulins - [CS]
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	BLA125077 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	07-27-2010 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	12-31-2019 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.

NDC Code Structure

61953 - Grifols Usa, Llc
- 61953-0005 - Flebogamma Dif
  - 61953-0005-2 - 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 61953-0005-2 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
61953000502	J1572	Flebogamma injection	500 MG	100	1	20	20

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Other Product Packages

The following packages are also available for Flebogamma Dif with product NDC 61953-0005.

NDC Package Code	Package Description
61953-0005-1	1 VIAL in 1 CARTON > 50 mL in 1 VIAL (61953-0005-4)
61953-0005-3	1 VIAL in 1 CARTON > 200 mL in 1 VIAL (61953-0005-6)

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