| Source HCPCS Code |
|
Target NDC Code |
J0476
INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
|
⇄
|
25021-0681-71
BACLOFEN (PF,LATEX-FREE) 0.05 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
08/20/2021 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0476
|
⇄
|
45945-0151-01
|
| 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 |
|
|
|
|
J0476
INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
|
⇄
|
58281-0562-01
LIORESAL INTRATHECAL SCREENING KIT (1X1 ML AMP) 0.05 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
7/10/2017 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
EA |
|
|
|
J0476
INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
|
⇄
|
66794-0151-01
GABLOFEN (1X1ML,SINGLE USE) 0.05 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
11/01/2017 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SR |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0476
INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
|
⇄
|
70121-2496-05
LIORESAL (PF,LATEX-FREE) 0.05 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
03/14/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0476
Injection, baclofen, 50 mcg for intrathecal trial
|
⇄
|
70257-0562-11
LIORESAL IT 0.05 MG/1 ML AM
|
| Detail Information |
| Relationship Start Date |
04/27/2017 |
| Relationship End Date |
03/31/2026 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AMPUL |
| Route Of Administration |
IT |
| Billing Units |
ML |
|
|
|
J0476
INJECTION, BACLOFEN, 50 MCG FOR INTRATHECAL TRIAL
|
⇄
|
70257-0562-55
LIORESAL INTRATHECAL (SCREENING #8563,PF) 0.05 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/10/2017 |
| Relationship End Date |
11/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
AM |
| Route Of Administration |
IN |
| Billing Units |
ML |
|
|
|
J0476
Baclofen intrathecal trial
|
⇄
|
70121-2496-05
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 |
|
|
|
|
J0476
Baclofen intrathecal trial
|
⇄
|
66794-0151-01
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 |
|
|
|
|
J0476
Baclofen intrathecal trial
|
⇄
|
25021-0681-71
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 |
|
|
|
|