| Source HCPCS Code |
|
Target NDC Code |
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
00003-2560-16
AZACTAM (SINGLE-DOSE,SODIUM-FREE) 1 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
00003-2570-16
AZACTAM (SINGLE-DOSE,SODIUM-FREE) 2 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
00409-0829-01
AZTREONAM (SDV,USP,PF,LATEX-FREE) 1 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
00409-0829-11
AZTREONAM 1 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
00409-0830-01
AZTREONAM (SDV,USP,PF,LATEX-FREE) 2 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
00409-0830-11
AZTREONAM 2 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0401-01
AZTREONAM 1 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
63323-0401-20
AZTREONAM (SDV,USP,SODIUM-FREE) 1 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0401-21
AZTREONAM 1 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
63323-0401-24
PREMIERPRO RX AZTREONAM (SDV,USP,SODIUM-FREE) 1 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
63323-0401-26
AZTREONAM NOVAPLUS (SDV,USP,LATEX-FREE) 1 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0401-41
AZTREONAM 1 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0402-01
AZTREONAM 2 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0402-03
AZTREONAM 2 GM VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2022 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
63323-0402-20
AZTREONAM (SDV,USP,SODIUM-FREE) 2 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
63323-0402-24
PREMIERPRO RX AZTREONAM (SDV,USP,SODIUM-FREE) 2 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
INJECTION, AZTREONAM, 100 MG
|
⇄
|
63323-0402-30
AZTREONAM NOVAPLUS (SDV,USP,LATEX-FREE) 2 GM
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0402-41
AZTREONAM 2 GM VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
EA |
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
50090-7494-00
Azactam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
00003-2560-16
Azactam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
00003-2570-16
Azactam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0401-20
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0401-24
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0401-26
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0402-20
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0402-24
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
63323-0402-30
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
00409-0829-01
Aztreonam
|
| 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 |
|
|
|
|
J0457
Injection, aztreonam, 100 mg
|
⇄
|
00409-0830-01
Aztreonam
|
| 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 |
|
|
|
|