| Source HCPCS Code |
|
Target NDC Code |
91322
SARSCOV2 VAC 50 MCG/0.5ML IM
|
⇄
|
80777-0110-93
SPIKEVAX (2024-2025) Preservative Free
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
91322
SARSCOV2 VAC 50 MCG/0.5ML IM
|
⇄
|
80777-0110-96
SPIKEVAX (2024-2025) Preservative Free
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
91322
SARSCOV2 VAC 50 MCG/0.5ML IM
|
⇄
|
80777-0112-88
SPIKEVAX 2025-26 (12Y UP) 50mcg/0.5 mL single dose SYRG
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|
91322
SARSCOV2 VAC 50 MCG/0.5ML IM
|
⇄
|
80777-0112-96
SPIKEVAX 2025-26 (12Y UP) 50mcg/0.5 mL single dose SYRG
|
| Detail Information |
| Relationship Start Date |
|
| Relationship End Date |
|
| Number Of Items In Ndc Package |
|
| Ndc Package Measure |
|
| Ndc Package Type |
|
| Route Of Administration |
|
| Billing Units |
|
|
|
|