| Source HCPCS Code |
|
Target NDC Code |
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0208-01
BRIXADI WEEKLY 8MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.16 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0216-01
BRIXADI WEEKLY 16MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.32 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0224-01
BRIXADI WEEKLY 24MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.48 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0228-01
BRIXADI MONTHLY 128MG 32 MG/0.09 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.36 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0232-01
BRIXADI WEEKLY 32MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.64 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0264-01
BRIXADI MONTHLY 64MG 32 MG/0.09 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.18 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J0576
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), 1 MG
|
⇄
|
58284-0296-01
BRIXADI MONTHLY 96MG 32 MG/0.09 ML
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
03/31/2024 |
| Number Of Items In Ndc Package |
0.27 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|