| Source HCPCS Code |
|
Target NDC Code |
C9168
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-7575-01
OMVOH 300 MG/15 ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
C9168
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-8011-01
OMVOH 100 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
C9168
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-8011-27
OMVOH 100 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|