| Source HCPCS Code |
|
Target NDC Code |
J0577
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), LESS THAN OR EQUAL TO 7 DAYS OF THERAPY
|
⇄
|
58284-0208-01
BRIXADI WEEKLY 8MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.16 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J0577
Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
|
⇄
|
58284-0208-91
BRIXADI WEEKLY 8 MG/0.16 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.16 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J0577
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), LESS THAN OR EQUAL TO 7 DAYS OF THERAPY
|
⇄
|
58284-0216-01
BRIXADI WEEKLY 16MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.32 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J0577
Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
|
⇄
|
58284-0216-91
BRIXADI WEEKLY 16 MG/0.32 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.32 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J0577
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), LESS THAN OR EQUAL TO 7 DAYS OF THERAPY
|
⇄
|
58284-0224-01
BRIXADI WEEKLY 24MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.48 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J0577
Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
|
⇄
|
58284-0224-91
BRIXADI WEEKLY 24 MG/0.48 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.48 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J0577
INJECTION, BUPRENORPHINE EXTENDED-RELEASE (BRIXADI), LESS THAN OR EQUAL TO 7 DAYS OF THERAPY
|
⇄
|
58284-0232-01
BRIXADI WEEKLY 32MG 8 MG/0.16 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
0.64 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
EA |
|
|
|
J0577
Injection, buprenorphine extended-release (brixadi), less than or equal to 7 days of therapy
|
⇄
|
58284-0232-91
BRIXADI WEEKLY 32 MG/0.64 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.64 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J0577
Inj, brixadi, 7 days or less
|
⇄
|
58284-0208-01
Brixadi (weekly dosing)
|
| 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 |
|
|
|
|
J0577
Inj, brixadi, 7 days or less
|
⇄
|
58284-0216-01
Brixadi (weekly dosing)
|
| 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 |
|
|
|
|
J0577
Inj, brixadi, 7 days or less
|
⇄
|
58284-0224-01
Brixadi (weekly dosing)
|
| 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 |
|
|
|
|
J0577
Inj, brixadi, 7 days or less
|
⇄
|
58284-0232-01
Brixadi (weekly dosing)
|
| 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 |
|
|
|
|