| Source HCPCS Code |
|
Target NDC Code |
J0174
INJECTION, LECANEMAB-IRMB, 1 MG
|
⇄
|
62856-0212-01
LEQEMBI (SDV,PF) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/06/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J0174
INJECTION, LECANEMAB-IRMB, 1 MG
|
⇄
|
62856-0215-01
LEQEMBI (SDV,PF) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/06/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J0174
Inj, lecanemab-irmb, 1 mg
|
⇄
|
62856-0212-01
Leqembi
|
| 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 |
|
|
|
|
J0174
Inj, lecanemab-irmb, 1 mg
|
⇄
|
62856-0215-01
Leqembi
|
| 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 |
|
|
|
|