| Source HCPCS Code |
|
Target NDC Code |
J0877
INJECTION, DAPTOMYCIN (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J0878, 1 MG
|
⇄
|
00409-0120-01
DAPTOMYCIN (SDV,PF,LATEX-FREE) 350 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J0877
INJECTION, DAPTOMYCIN (HOSPIRA), NOT THERAPEUTICALLY EQUIVALENT TO J0878, 1 MG
|
⇄
|
00409-0122-01
DAPTOMYCIN (SDV,PF,LATEX-FREE) 500 MG
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| 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 |
|
|
|
J0877
Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg
|
⇄
|
00409-2757-01
DAPTOMYCIN 500 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
10/03/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0877
Injection, daptomycin (hospira), not therapeutically equivalent to j0878, 1 mg
|
⇄
|
00409-5933-01
DAPTOMYCIN 350 MG VIAL
|
| Detail Information |
| Relationship Start Date |
01/01/2023 |
| Relationship End Date |
12/31/2023 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J0877
Inj, daptomycin (hospira)
|
⇄
|
00143-9445-01
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 |
|
|
|
|
J0877
Inj, daptomycin (hospira)
|
⇄
|
00409-0120-01
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 |
|
|
|
|
J0877
Inj, daptomycin (hospira)
|
⇄
|
00409-0122-01
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 |
|
|
|
|