NDC 67684-2000-4 Dotarem

Gadoterate Meglumine

NDC Package Code 67684-2000-4

The NDC Code 67684-2000-4 is assigned to a package of 6 vial in 1 package > 100 ml in 1 vial of Dotarem, a human prescription drug labeled by Guerbet Llc. The product's dosage form is injection and is administered via intravenous form.This product is billed per "ML" milliliter and contains an estimated amount of 600 billable units per package.

Field Name	Field Value
NDC Code	67684-2000-4
Package Description	6 VIAL in 1 PACKAGE > 100 mL in 1 VIAL
Proprietary Name	Dotarem 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	Gadoterate Meglumine 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	67684200004 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.
Estimated Billable Units per Package	600 ML
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	Guerbet Llc
Dosage Form	Injection - A sterile preparation intended for parenteral use; five distinct classes of injections exist as defined by the USP.
Administration Route(s)	Intravenous - Administration within or into a vein or veins. Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)	GADOTERATE MEGLUMINE 376.9 mg/mL GADOTERATE MEGLUMINE 376.9 mg/mL
Pharmacological Class(es)	Gadolinium-based Contrast Agent - [EPC] (Established Pharmacologic Class) Magnetic Resonance Contrast Activity - [MoA] (Mechanism of Action) Gadolinium-based Contrast Agent - [EPC] (Established Pharmacologic Class) Magnetic Resonance Contrast Activity - [MoA] (Mechanism of Action)
Sample Package	No Sample Package? This field Indicates whether this package is a sample packaging or not.
Marketing Category	NDA - A product marketed under an approved New Drug 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	NDA204781 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	03-20-2013 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	12-31-2022 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.
Exclude Flag	N What is the NDC Exclude Flag? This field indicates whether the product has been removed/excluded from the NDC Directory for failure to respond to FDA"s requests for correction to deficient or non-compliant submissions ("Y"), or because the listing certification is expired ("E"), or because the listing data was inactivated by FDA ("I"). Values = "Y", "N", "E", or "I".

NDC Code Structure

67684 - Guerbet Llc
- 67684-2000 - Dotarem
  - 67684-2000-4 - 6 VIAL in 1 PACKAGE

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 67684-2000-4 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
67684200004	A9575	Inj gadoterate meglumi 0.1ml	0.1 ML	100	6	1000	6000

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Other Product Packages

The following packages are also available for Dotarem with product NDC 67684-2000.

NDC Package Code	Package Description
67684-2000-0	10 VIAL in 1 PACKAGE > 5 mL in 1 VIAL
67684-2000-1	10 VIAL in 1 PACKAGE > 10 mL in 1 VIAL
67684-2000-2	10 VIAL in 1 PACKAGE > 15 mL in 1 VIAL
67684-2000-3	10 VIAL in 1 PACKAGE > 20 mL in 1 VIAL
67684-2000-5	5 SYRINGE in 1 PACKAGE > 10 mL in 1 SYRINGE
67684-2000-6	5 SYRINGE in 1 PACKAGE > 15 mL in 1 SYRINGE
67684-2000-7	5 SYRINGE in 1 PACKAGE > 20 mL in 1 SYRINGE

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