Lutrate Depot
NDC Package 69112-002-02

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.

Lutrate Depot is a . Marketed by Gp Pharm Sa, this product is identified by NDC 69112-002 and is authorized under FDA application NDA205054.

Identification & Billing

NDC Package Code
69112-002-02
Package Description
1 KIT in 1 CARTON * 2 mL in 1 SYRINGE * 1 INJECTION, POWDER, LYOPHILIZED, FOR SUSPENSION, EXTENDED RELEASE in 1 VIAL
Product Code
69112-002
11-Digit Billing Format
69112000202

Clinical Specifications

Proprietary Name
Lutrate Depot
Dosage Form
-

Regulatory & Marketing

Labeler Name
Gp Pharm Sa
FDA Application #
NDA205054
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
06-27-2022
End Marketing Date
06-27-2022
Listing Expiration
06-27-2022
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 69112-002-02 identifies a specific commercial package of 1 kit in 1 carton * 2 ml in 1 syringe * 1 injection, powder, lyophilized, for suspension, extended release in 1 vial of Lutrate Depot, labeled by Gp Pharm Sa. 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 Gp Pharm Sa on June 27, 2022. The current certification is valid through June 27, 2022.

How is this Gp Pharm Sa product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 69112000202. 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)
69112-002-02
11-Digit CMS (5-4-2)
69112-0002-02

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