Leukotrap Rc System Solution
NDC Package 87069-129-63

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

Package Information

Leukotrap Rc System (cp2d/as-3 triple blood bag unit with in-line rc2d filter and sampling system) solution is a human prescription drug administered via intravenous route. This formulation utilizes a solution delivery system. Marketed by Gvs Tm Inc, this product is identified by NDC 87069-129 and is authorized under FDA application BN820915.

Identification & Billing

NDC Package Code
87069-129-63
Package Description
18 POUCH in 1 CARTON / 3 BAG in 1 POUCH / 70 mL in 1 BAG
Product Code
87069-129
11-Digit Billing Format
87069012963

Clinical Specifications

Proprietary Name
Leukotrap Rc System
Non-Proprietary Name
Cp2d/as-3 Triple Blood Bag Unit With In-line Rc2d Filter And Sampling System
Substance Name
Dextrose, Unspecified Form
Dosage Form
Solution - A clear, homogeneous liquid1 dosage form that contains one or more chemical substances dissolved in a solvent or mixture of mutually miscible solvents.
Administration Route
Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
DEXTROSE, UNSPECIFIED FORM 3.57 g/70mL

Regulatory & Marketing

Labeler Name
Gvs Tm Inc
Product Type
Human Prescription Drug
FDA Application #
BN820915
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
03-02-2026
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 87069-129-63 identifies a specific commercial package of 18 pouch in 1 carton / 3 bag in 1 pouch / 70 ml in 1 bag of Leukotrap Rc System, a human prescription drug labeled by Gvs Tm Inc. This solution is formulated for intravenous use and contains dextrose, unspecified form 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 Gvs Tm Inc on March 02, 2026. The current certification is valid through December 31, 2027.

How is this Gvs Tm Inc product billed for insurance claims?

For medical billing and reimbursement, this package follows the 11-digit CMS format: 87069012963. 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)
87069-129-63
11-Digit CMS (5-4-2)
87069-0129-63

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