| Source HCPCS Code |
|
Target NDC Code |
J0614
Injection, treosulfan, 50 mg
|
⇄
|
59137-0335-00
GRAFAPEX 1 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0614
INJECTION, TREOSULFAN, 50 MG
|
⇄
|
59137-0335-01
GRAFAPEX SDV,LYOPHILIZED 1 GM
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0614
Injection, treosulfan, 50 mg
|
⇄
|
59137-0365-00
GRAFAPEX 5 GRAM VIAL
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0614
INJECTION, TREOSULFAN, 50 MG
|
⇄
|
59137-0365-01
GRAFAPEX SDV,LYOPHILIZED 5 GM
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0614
Inj, treosulfan, 50 mg
|
⇄
|
59137-0335-01
Grafapex
|
| 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 |
|
|
|
|
J0614
Inj, treosulfan, 50 mg
|
⇄
|
59137-0365-01
Grafapex
|
| 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 |
|
|
|
|