| Source HCPCS Code |
|
Target NDC Code |
J0872
INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG
|
⇄
|
00143-9445-01
DAPTOmycin SDV,LYOPHILIZED 500 MG
|
| Detail Information |
| Relationship Start Date |
12/11/2025 |
| 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 |
|
|
|
J0872
INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG
|
⇄
|
70594-0060-01
DAPTOMYCIN (SDV,PF,LYOPHILIZED) 500 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| 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 |
|
|
|
J0872
INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG
|
⇄
|
70594-0066-01
DAPTOMYCIN (SDV,PF,LYOPHILIZED) 350 MG
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| 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 |
|
|
|
J0872
INJECTION, DAPTOMYCIN (XELLIA), UNREFRIGERATED, NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0873, 1 MG
|
⇄
|
72572-0158-01
DAPTOmycin SDV,LYOPHILIZED 500 MG
|
| Detail Information |
| Relationship Start Date |
01/28/2026 |
| 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 |
|
|
|
J0872
Daptomycin (xellia) unrefrig
|
⇄
|
70594-0060-01
Daptomycin
|
| 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 |
|
|
|
|
J0872
Daptomycin (xellia) unrefrig
|
⇄
|
70594-0066-01
Daptomycin
|
| 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 |
|
|
|
|