Leukotrap Wb System Solution
NDC Package 87069-136-62

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

Package Information

Leukotrap Wb System (cpda-1 blood bag collection system) solution is classified as a

administered via intravenous route. This formulation utilizes a solution delivery system. Marketed by Gvs Tm Inc, this product is identified by NDC 87069-136 and is authorized under FDA application BN800077.

Identification & Billing

NDC Package Code
87069-136-62
Package Description
6 POUCH in 1 CARTON / 3 BAG in 1 POUCH / 70 mL in 1 BAG
Product Code
87069-136
11-Digit Billing Format
87069013662

Clinical Specifications

Proprietary Name
Leukotrap Wb System
Non-Proprietary Name
Cpda-1 Blood Bag Collection System
Substance Name
Dextrose Monohydrate; Sodium Citrate; Sodium Phosphate, Monobasic, Monohydrate; Adenine; Citric Acid Monohydrate
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.
  • Intravenous - Administration within or into a vein or veins.
Active Ingredient(s)
Pharmacologic Class

Regulatory & Marketing

Labeler Name
Gvs Tm Inc
Product Type
Human Prescription Drug
FDA Application #
BN800077
Marketing Category
NDA - A product marketed under an approved New Drug Application.
Start Marketing Date
06-24-2026
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.

Other Available Packages

The following commercial packages are registered under the same Product NDC (87069-136). Click a package code to view its specific billing and regulatory data.

87069-136-64
6 POUCH in 1 CARTON / 3 BAG in 1 POUCH / 70 mL in 1 BAG

* 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 87069-136-62 identifies a specific commercial package of 6 pouch in 1 carton / 3 bag in 1 pouch / 70 ml in 1 bag of Leukotrap Wb System, a human prescription drug labeled by Gvs Tm Inc. This solution is formulated for intravenous use and contains dextrose monohydrate; sodium citrate; sodium phosphate, monobasic, monohydrate; adenine; citric acid monohydrate 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 June 24, 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: 87069013662. 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)
87069-136-62
11-Digit CMS (5-4-2)
87069-0136-62

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