Photofrin Injection, Powder, For Solution
NDC Package 76128-155-75

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

Package Information

Photofrin (porfimer sodium) injection is pHOTOFRIN® is indicated for the palliation of patients with completely obstructing esophageal cancer, or of patients with partially obstructing esophageal cancer who, in the opinion of their healthcare provider, cannot be satisfactorily treated with Nd:YAG laser therapy. This formulation utilizes a injection, powder, for solution delivery system. Marketed by Pinnacle Biologics, Inc., this product is identified by NDC 76128-155 and is authorized under FDA application NDA020451.

Identification & Billing

NDC Package Code
76128-155-75
Package Description
1 VIAL in 1 BOX, UNIT-DOSE / 31.8 mL in 1 VIAL
Product Code
76128-155
11-Digit Billing Format
76128015575
Billing Unit
EA - Billing unit of "each" is used when the product is dispensed in discreet units.
Units Per Package
1 EA
RxNorm Crosswalk

Clinical Specifications

Proprietary Name
Photofrin
Non-Proprietary Name
Porfimer Sodium
Substance Name
Porfimer Sodium
Dosage Form
Injection, Powder, For Solution - A sterile preparation intended for reconstitution to form a solution for parenteral use.
Administration Route
Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
PORFIMER SODIUM 75 mg/31.8mL
Pharmacologic Class
Usage Information
PHOTOFRIN® is indicated for the palliation of patients with completely obstructing esophageal cancer, or of patients with partially obstructing esophageal cancer who, in the opinion of their healthcare provider, cannot be satisfactorily treated with Nd:YAG laser therapy.

Regulatory & Marketing

Labeler Name
Pinnacle Biologics, Inc.
Product Type
Human Prescription Drug
FDA Application #
NDA020451
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
12-27-1995
Listing Expiration
12-31-2027
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.

Frequently Asked Questions

What is the distribution configuration for this product package?

The code 76128-155-75 identifies a specific commercial package of 1 vial in 1 box, unit-dose / 31.8 ml in 1 vial of Photofrin, a human prescription drug labeled by Pinnacle Biologics, Inc.. This product is billed for "EA" each discreet unit and contains an estimated amount of 1 billable units per package. This injection, powder, for solution is formulated for intravenous use and contains porfimer sodium 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 Pinnacle Biologics, Inc. on December 27, 1995. The current certification is valid through December 31, 2027.

How is this Pinnacle Biologics, Inc. product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 76128015575. Quantities are measured in per "each", products billed on a per each basis are usually products dispensed in discreet units.. There are 1 total billable units per package. 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)
76128-155-75
11-Digit CMS (5-4-2)
76128-0155-75

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