Folotyn Injection
NDC Package 72893-005-01

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

Package Information

Folotyn (pralatrexate) injection is pralatrexate is used to treat a certain type of cancer (peripheral T-Cell lymphoma-PTCL). This formulation utilizes a injection delivery system. Marketed by Acrotech Biopharma Inc, this product is identified by NDC 72893-005 and is authorized under FDA application NDA022468.

Identification & Billing

NDC Package Code
72893-005-01
Package Description
1 VIAL in 1 CARTON / 2 mL in 1 VIAL
Product Code
72893-005
11-Digit Billing Format
72893000501
Billing Unit
ML - Billing unit of "milliliter" is used when a product is measured by its liquid volume.
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Folotyn
Non-Proprietary Name
Pralatrexate
Substance Name
Pralatrexate
Dosage Form
Injection - A sterile preparation intended for parenteral use; five distinct classes of injections exist as defined by the USP.
Administration Route
Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
PRALATREXATE 40 mg/2mL
Pharmacologic Class
Folate Analog Metabolic Inhibitor - [EPC] (Established Pharmacologic Class)
Usage Information
Pralatrexate is used to treat a certain type of cancer (peripheral T-Cell lymphoma-PTCL). Pralatrexate works by slowing or stopping the growth of cancer cells.

Regulatory & Marketing

Labeler Name
Acrotech Biopharma Inc
Product Type
Human Prescription Drug
FDA Application #
NDA022468
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
09-24-2009
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.

Billing & HCPCS Mapping

To facilitate insurance claims and reimbursement, this drug package is mapped to specific HCPCS administrative codes. This crosswalk aligns clinical data with the billing standards used in ASP (Average Sales Price), AWP, and OPPS payment systems. Use the cards below to identify the correct billable units for provider claims.

J9307
Source: ASP
Pralatrexate injection
HCPCS Dosage 1 MG
Units / Pkg 40

Note for Medical Coders: These mappings are synthesized from various CMS datasets including OPPS, PrEP, and DAC (Data Analysis and Coding) contractors. Always confirm unit conversions against the current quarter's pricing files before final submission.

* 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 72893-005-01 identifies a specific commercial package of 1 vial in 1 carton / 2 ml in 1 vial of Folotyn, a human prescription drug labeled by Acrotech Biopharma Inc. This injection is formulated for intravenous use and contains pralatrexate 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 Acrotech Biopharma Inc on September 24, 2009. The current certification is valid through December 31, 2026.

What are the primary indications for this medication?

Pralatrexate is used to treat a certain type of cancer (peripheral T-Cell lymphoma-PTCL). Pralatrexate works by slowing or stopping the growth of cancer cells.

How is this Acrotech Biopharma Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 72893000501. Quantities are measured in per "ml or milliliter", products billed per milliliter are usually products measured by liquid volume.. 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)
72893-005-01
11-Digit CMS (5-4-2)
72893-0005-01

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