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  5. NDC Package Code: 69387-001-01 Bafiertam

NDC Package 69387-001-01 Bafiertam

Monomethyl Fumarate Capsule Oral - View Billable Units, 11-Digit Format, RxNorm

Table of Contents

    1. Package Information
    2. Frequently Asked Questions

Package Information

Find all the important details about this NDC Package code, including the 11-Digit NDC Billing number, billing units, wholesale price, RxNorm crosswalk, active ingredients, pharmacologic clasess, etc.

NDC Package Code:
69387-001-01
Package Description:
120 CAPSULE in 1 BOTTLE
Product Code:
69387-001
Proprietary Name:
Bafiertam
Non-Proprietary Name:
Monomethyl Fumarate
Substance Name:
Monomethyl Fumarate
Usage Information:
BAFIERTAM is indicated for the treatment of relapsing forms of multiple sclerosis (MS), to include clinically isolated syndrome, relapsing-remitting disease, and active secondary progressive disease, in adults.
11-Digit NDC Billing Format:
69387000101
Billing Unit:
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
NDC to RxNorm Crosswalk:
120 EA
NDC to RxNorm Crosswalk:
  • RxCUI: 2393587 - monomethyl fumarate 95 MG Delayed Release Oral Capsule
  • RxCUI: 2393593 - Bafiertam 95 MG Delayed Release Oral Capsule
  • RxCUI: 2393593 - monomethyl fumarate 95 MG Delayed Release Oral Capsule [Bafiertam]
    • Product Type:
    Human Prescription Drug
    Labeler Name:
    Banner Life Sciences Llc
    Dosage Form:
    Capsule - A solid oral dosage form consisting of a shell and a filling. The shell is composed of a single sealed enclosure, or two halves that fit together and which are sometimes sealed with a band. Capsule shells may be made from gelatin, starch, or cellulose, or other suitable materials, may be soft or hard, and are filled with solid or liquid ingredients that can be poured or squeezed.
    Administration Route(s):
  • Oral - Administration to or by way of the mouth.
    • Active Ingredient(s):
  • MONOMETHYL FUMARATE 95 mg/1
    • Sample Package:
    No
    FDA Application Number:
    NDA210296
    Marketing Category:
    NDA - A product marketed under an approved New Drug Application.
    Start Marketing Date:
    04-28-2020
    Listing Expiration Date:
    12-31-2024
    Exclude Flag:
    N
    Code Structure:

    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 disclaimer below.

    Frequently Asked Questions

    What is NDC 69387-001-01?

    The NDC Packaged Code 69387-001-01 is assigned to a package of 120 capsule in 1 bottle of Bafiertam, a human prescription drug labeled by Banner Life Sciences Llc. The product's dosage form is capsule and is administered via oral form.This product is billed for "EA" each discreet unit and contains an estimated amount of 120 billable units per package.

    Is NDC 69387-001 included in the NDC Directory?

    Yes, Bafiertam with product code 69387-001 is active and included in the NDC Directory. The product was first marketed by Banner Life Sciences Llc on April 28, 2020 and its listing in the NDC Directory is set to expire on December 31, 2024 if the product is not updated or renewed by the manufacturer.

    What is the NDC billing unit for package 69387-001-01?

    The contents of this package are billed per "each", products billed on a per each basis are usually products dispensed in discreet units. The calculated billable units for this package is 120.

    What is the 11-digit format for NDC 69387-001-01?

    The 11-digit format is 69387000101. The 11-digit billing format might be required by the Centers for Medicare & Medicaid Services (CMS) and other payers in billing claim forms.

    This package code is originally configured in a 5-3-2 segment 10-digit format and by adding a zero within the original NDC package code we can obtain the converted 11-digit format in a 5-4-2 segment configuration. The table below shows the 11-digit code conversion:

    10-Digit Format10-Digit Original Code11-Digit Format11-Digit Code
    5-3-269387-001-015-4-269387-0001-01