Egrifta Wr Kit
NDC Package 62064-381-04

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

Package Information

Egrifta Wr (tesamorelin) kits is eGRIFTA WR is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy.Limitations of Use:Long-term cardiovascular safety of EGRIFTA WR has not been established. This formulation utilizes a kit delivery system. Marketed by Theratechnologies Inc., this product is identified by NDC 62064-381 and is authorized under FDA application BLA022505.

Identification & Billing

NDC Package Code
62064-381-04
Package Description
1 KIT in 1 BOX * 1.3 mL in 1 VIAL (62064-371-01) * 30 mL in 1 BOTTLE
Product Code
62064-381
11-Digit Billing Format
62064038104
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Egrifta Wr
Non-Proprietary Name
Tesamorelin
Dosage Form
Kit - A packaged collection of related material.
Administration Route
Subcutaneous - Administration beneath the skin; hypodermic. Synonymous with the term SUBDERMAL.
Usage Information
EGRIFTA WR is indicated for the reduction of excess abdominal fat in HIV-infected adult patients with lipodystrophy.Limitations of Use:Long-term cardiovascular safety of EGRIFTA WR has not been established. Consider risk/benefit of continuation of treatment in patients who have not had a reduction in visceral adipose tissue.EGRIFTA WR is not indicated for weight loss management as it has a weight neutral effect.There are no data to support improved compliance with anti-retroviral therapies in HIV-positive patients taking EGRIFTA WR.

Regulatory & Marketing

Labeler Name
Theratechnologies Inc.
Product Type
Human Prescription Drug
FDA Application #
BLA022505
Marketing Category
BLA - A product marketed under an approved Biologic License Application.
Start Marketing Date
07-15-2025
Listing Expiration
12-31-2026
Exclude Flag
N
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 62064-381-04 identifies a specific commercial package of 1 kit in 1 box * 1.3 ml in 1 vial (62064-371-01) * 30 ml in 1 bottle of Egrifta Wr, a human prescription drug labeled by Theratechnologies Inc.. This kit is formulated for subcutaneous use and contains as the active substance.

Is this product currently listed with the FDA?

Yes, this product is active and verified within the NDC Directory. It was introduced to the market by Theratechnologies Inc. on July 15, 2025. The current certification is valid through December 31, 2026.

How is this Theratechnologies Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 62064038104. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. 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)
62064-381-04
11-Digit CMS (5-4-2)
62064-0381-04

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