| Source HCPCS Code |
|
Target NDC Code |
J0873
INJECTION, DAPTOMYCIN (XELLIA) NOT THERAPEUTICALLY EQUIVALENT TO J0878, 1 MG
|
⇄
|
70594-0053-01
DAPTOMYCIN (PF,LYOPHILIZED) 350 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| 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 |
|
|
|
J0873
Injection, daptomycin (xellia), not therapeutically equivalent to j0878 or
|
⇄
|
70594-0060-01
DAPTOMYCIN 500 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0873
Injection, daptomycin (xellia) not therapeutically equivalent to J0878, 1 mg
|
⇄
|
70594-0066-01
DAPTOMYCIN 350 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
06/30/2024 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0873
INJECTION, DAPTOMYCIN (XELLIA), NOT THERAPEUTICALLY EQUIVALENT TO J0878 OR J0872, 1 MG
|
⇄
|
72572-0100-01
DAPTOMYCIN LYOPHILIZED 350 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| 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 |
|
|
|
J0873
Inj daptomycin (xellia)
|
⇄
|
72572-0100-01
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 |
|
|
|
|
J0873
Inj daptomycin (xellia)
|
⇄
|
70594-0053-01
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 |
|
|
|
|