| Source HCPCS Code |
|
Target NDC Code |
J0475
Injection, baclofen, 10 mg
|
⇄
|
14789-0161-01
BACLOFEN 40 MG/20 ML REFLL KIT
|
| Detail Information |
| Relationship Start Date |
03/08/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
14789-0161-05
BACLOFEN (SDV,PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/08/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
14789-0161-07
BACLOFEN 40,000 MCG/20 ML VIAL
|
| Detail Information |
| Relationship Start Date |
03/08/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
25021-0678-20
BACLOFEN (PF,LATEX-FREE) 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
08/20/2021 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
25021-0679-20
BACLOFEN (PF,LATEX-FREE) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
08/20/2021 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
25021-0680-20
BACLOFEN (PF,LATEX-FREE) 1 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
08/20/2021 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
25021-0681-71
BACLOFEN 0.05 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
08/24/2021 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
38779-0388-03
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
38779-0388-04
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
38779-0388-05
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
38779-0388-09
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
04/22/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
|
⇄
|
45945-0155-01
|
| 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 |
|
|
|
|
J0475
|
⇄
|
45945-0155-02
|
| 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 |
|
|
|
|
J0475
|
⇄
|
45945-0156-01
|
| 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 |
|
|
|
|
J0475
|
⇄
|
45945-0156-02
|
| 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 |
|
|
|
|
J0475
|
⇄
|
45945-0157-01
|
| 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 |
|
|
|
|
J0475
|
⇄
|
45945-0157-02
|
| 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 |
|
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
49452-0807-01
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
11/15/2004 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
49452-0807-02
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
49452-0807-03
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
49452-0807-04
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
51552-0613-02
BACLOFEN (1X5GM)
|
| Detail Information |
| Relationship Start Date |
09/01/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
51552-0613-04
BACLOFEN (1X25GM)
|
| Detail Information |
| Relationship Start Date |
09/01/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
51552-0613-05
BACLOFEN (1X100GM)
|
| Detail Information |
| Relationship Start Date |
09/01/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
51927-2007-00
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
09/08/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
58281-0560-01
LIORESAL INTRATHECAL REFILL KIT (1X20 ML AMP) 0.5 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
IN |
| Billing Units |
EA |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
58281-0560-02
LIORESAL INTRATHECAL REFILL KIT (2X20ML AMP) 0.5 MG/ML
|
| Detail Information |
| Relationship Start Date |
4/2/2004 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
58281-0561-02
LIORESAL INTRATHECAL REFILL KIT (2X5 ML AMP) 2 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
IN |
| Billing Units |
EA |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
58281-0561-04
LIORESAL INTRATHECAL REFILL KIT (4X5 ML AMP) 2 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/20/2003 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
EA |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
58281-0563-01
LIORESAL INTRATHECAL REFILL KIT (1X20ML AMP) 2 MG/ML
|
| Detail Information |
| Relationship Start Date |
10/21/2003 |
| Relationship End Date |
7/23/2017 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
58281-0563-02
LIORESAL INTRATHECAL REFILL KIT (2X20ML AMP) 2 MG/ML
|
| Detail Information |
| Relationship Start Date |
4/2/2004 |
| Relationship End Date |
7/23/2017 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
62991-1013-01
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
62991-1013-02
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
62991-1013-03
BACLOFEN
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
62991-1013-04
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
09/15/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63275-9992-02
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
12/04/2002 |
| Relationship End Date |
05/31/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63275-9992-04
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
12/04/2002 |
| Relationship End Date |
05/31/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63275-9992-05
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
12/04/2002 |
| Relationship End Date |
05/31/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63370-0026-15
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63370-0026-25
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63370-0026-35
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
63370-0026-45
BACLOFEN (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
66794-0151-01
GABLOFEN 50 MCG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
01/31/2018 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
66794-0155-01
GABLOFEN (1X20ML,SINGLE USE) 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
66794-0155-02
GABLOFEN (1X20ML,SINGLE USE) 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
66794-0156-01
GABLOFEN (1X20ML,SINGLE USE) 1 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
02/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
66794-0156-02
GABLOFEN (1X20ML,SINGLE USE) 1 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
66794-0157-01
GABLOFEN (1X20ML,SINGLE USE) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
66794-0157-02
GABLOFEN (1X20ML,SINGLE USE) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2018 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
67457-0562-20
BACLOFEN (SDV) 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
12/21/2018 |
| Relationship End Date |
02/28/2025 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
67457-0563-20
BACLOFEN (SDV) 1 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
12/21/2018 |
| Relationship End Date |
02/28/2025 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
67457-0564-20
BACLOFEN (SDV) 1 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
12/21/2018 |
| Relationship End Date |
08/31/2025 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
70121-2494-01
LIORESAL IT 10 MG/5 ML AMPULE
|
| Detail Information |
| Relationship Start Date |
07/12/2016 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AMPUL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
70121-2495-01
LIORESAL IT 40 MG/20 ML AMP
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AMPUL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70121-2501-01
LIORESAL REFILL KIT (8561,PF,LATEX-FREE) 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/14/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70121-2502-02
LIORESAL REFILL KIT (8562,PF,LATEX-FREE) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/14/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70121-2503-01
LIORESAL REFILL KIT (8564,PF,LATEX-FREE) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/14/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70121-2504-02
LIORESAL REFILL KIT (8565,PF,LATEX-FREE) 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/14/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70121-2505-02
LIORESAL REFILL KIT (8566,PF,LATEX-FREE) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/14/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70257-0560-01
LIORESAL INTRATHECAL REFILL KIT 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/25/2018 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70257-0560-02
LIORESAL INTRATHECAL REFILL KIT 0.5 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/25/2018 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
70257-0560-20
LIORESAL IT 10 MG/20 ML AMP
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AMPUL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70257-0561-02
LIORESAL INTRATHECAL REFILL KIT 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
01/25/2018 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
70257-0561-05
LIORESAL IT 10 MG/5 ML AMPU
|
| Detail Information |
| Relationship Start Date |
07/01/2022 |
| Relationship End Date |
05/25/2024 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AMPUL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70257-0563-01
LIORESAL INTRATHECAL REFILL KIT (PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/24/2017 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
INJECTION, BACLOFEN, 10 MG
|
⇄
|
70257-0563-02
LIORESAL INTRATHECAL REFILL KIT (PF) 2 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/24/2017 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0475
Injection, baclofen, 10 mg
|
⇄
|
70257-0563-20
LIORESAL IT 40 MG/20 ML AMP
|
| Detail Information |
| Relationship Start Date |
04/27/2017 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AMPUL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
70121-2501-01
Lioresal
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
70121-2502-02
Lioresal
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
70121-2503-01
Lioresal
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
70121-2504-02
Lioresal
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
70121-2505-02
Lioresal
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
67457-0562-20
Baclofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
67457-0563-20
Baclofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
67457-0564-20
Baclofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
14789-0161-05
Baclofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
66794-0155-01
Gablofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
66794-0155-02
Gablofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
66794-0156-01
Gablofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
66794-0156-02
Gablofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
66794-0157-01
Gablofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
66794-0157-02
Gablofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
25021-0678-20
Baclofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
25021-0679-20
Baclofen
|
| 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 |
|
|
|
|
J0475
Baclofen 10 mg injection
|
⇄
|
25021-0680-20
Baclofen
|
| 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 |
|
|
|
|