NDC Package 72493-103-03 Jelmyto

Mitomycin Kit - View Billable Units, 11-Digit Format, RxNorm

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:
72493-103-03
Package Description:
1 KIT in 1 CARTON * 20 mL in 1 VIAL, SINGLE-DOSE (72493-102-20) * 1 POWDER, FOR SOLUTION in 1 VIAL, SINGLE-DOSE (72493-101-40)
Product Code:
Proprietary Name:
Jelmyto
Non-Proprietary Name:
Mitomycin
Usage Information:
Mitomycin is used to treat various types of cancer (such as stomach/pancreas cancer). It works by slowing or stopping the growth of cancer cells.
11-Digit NDC Billing Format:
72493010303
Billing Unit:
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
NDC to RxNorm Crosswalk:
  • RxCUI: 2375818 - mitoMYcin 40 MG Powder for Pyelocalyceal Solution
  • RxCUI: 2375818 - mitomycin 40 MG Powder for Pyelocalyceal Solution
  • RxCUI: 2375818 - mitoMYcin 40 MG Powder for Ureteral Solution
  • RxCUI: 2375823 - Jelmyto 40 MG Powder for Pyelocalyceal Solution
  • RxCUI: 2375823 - mitomycin 40 MG Powder for Pyelocalyceal Solution [Jelmyto]
  • Product Type:
    Human Prescription Drug
    Labeler Name:
    Urogen Pharma, Inc.
    Dosage Form:
    Kit - A packaged collection of related material.
    Sample Package:
    No
    FDA Application Number:
    NDA211728
    Marketing Category:
    NDA - A product marketed under an approved New Drug Application.
    Start Marketing Date:
    05-01-2020
    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.

    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 72493-103-03 HCPCS crosswalk information with package details and bill units information.

    NDC Billing CodeHCPCS CodeHCPCS Code Desc.DosagePackage SizePackage QuantityBillable UnitsBillable Units / Pkg
    72493010303J9281Mitomycin instillation1 MG124080

    * Please review the disclaimer below.

    Frequently Asked Questions

    What is NDC 72493-103-03?

    The NDC Packaged Code 72493-103-03 is assigned to a package of 1 kit in 1 carton * 20 ml in 1 vial, single-dose (72493-102-20) * 1 powder, for solution in 1 vial, single-dose (72493-101-40) of Jelmyto, a human prescription drug labeled by Urogen Pharma, Inc.. The product's dosage form is kit and is administered via form.

    Is NDC 72493-103 included in the NDC Directory?

    Yes, Jelmyto with product code 72493-103 is active and included in the NDC Directory. The product was first marketed by Urogen Pharma, Inc. on May 01, 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 72493-103-03?

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

    What is the 11-digit format for NDC 72493-103-03?

    The 11-digit format is 72493010303. 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
    5-3-272493-103-035-4-272493-0103-03