| Source HCPCS Code |
|
Target NDC Code |
J0802
Injection, corticotropin (ani), up to 40 units
|
⇄
|
62559-0860-11
CORTROPHIN GEL 80 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J0802
Inj, corticotropin (ani), up to 40 units
|
⇄
|
62559-0860-15
CORTROPHIN GEL 400 UNIT/5 M
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J0802
Injection, corticotropin (ani), up to 40 units
|
⇄
|
62559-0861-11
CORTROPHIN GEL 80 UNIT/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/17/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J0802
Injection, corticotropin (ani), up to 40 units
|
⇄
|
62559-0861-35
CORTROPHIN GEL 40 UNIT/0.5 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/17/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
0.5 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J0802
Inj. (ani), up to 40 units
|
⇄
|
62559-0860-11
Purified Cortrophin Gel
|
| 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 |
|
|
|
|
J0802
Inj. (ani), up to 40 units
|
⇄
|
62559-0860-15
Cortrophin Gel
|
| 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 |
|
|
|
|