| Source HCPCS Code |
|
Target NDC Code |
J0642
INJECTION, LEVOLEUCOVORIN (KHAPZORY), 0.5 MG
|
⇄
|
68152-0112-01
KHAPZORY (PF,LYOPHILIZED) 175 MG
|
| Detail Information |
| Relationship Start Date |
10/01/2019 |
| Relationship End Date |
05/11/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0642
INJECTION, LEVOLEUCOVORIN (KHAPZORY), 0.5 MG
|
⇄
|
68152-0114-01
KHAPZORY (PF,LYOPHILIZED) 300 MG
|
| Detail Information |
| Relationship Start Date |
10/01/2019 |
| Relationship End Date |
04/11/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0642
INJECTION, LEVOLEUCOVORIN (KHAPZORY), 0.5 MG
|
⇄
|
72893-0004-01
KHAPZORY (PF,LYOPHILIZED) 175 MG
|
| Detail Information |
| Relationship Start Date |
05/12/2021 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0642
INJECTION, LEVOLEUCOVORIN (KHAPZORY), 0.5 MG
|
⇄
|
72893-0006-01
KHAPZORY (PF,LYOPHILIZED) 300 MG
|
| Detail Information |
| Relationship Start Date |
04/12/2021 |
| Relationship End Date |
10/31/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
VL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0642
Injection, khapzory, 0.5 mg
|
⇄
|
72893-0004-01
Khapzory
|
| 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 |
|
|
|
|