| Source HCPCS Code |
|
Target NDC Code |
J1105
Dexmedetomidine, oral, 1 mcg
|
⇄
|
81092-1120-00
IGALMI 120 MCG SL FILM
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
PACKET |
| Route Of Administration |
SL |
| Billing Units |
EA |
|
|
|
J1105
Dexmedetomidine, oral, 1 mcg
|
⇄
|
81092-1120-01
IGALMI 120 MCG SL FILM
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
PACKET |
| Route Of Administration |
SL |
| Billing Units |
EA |
|
|
|
J1105
Dexmedetomidine, oral, 1 mcg
|
⇄
|
81092-1180-00
IGALMI 180 MCG SL FILM
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
PACKET |
| Route Of Administration |
SL |
| Billing Units |
EA |
|
|
|
J1105
Dexmedetomidine, oral, 1 mcg
|
⇄
|
81092-1180-01
IGALMI 180 MCG SL FILM
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
UN |
| Ndc Package Type |
PACKET |
| Route Of Administration |
SL |
| Billing Units |
EA |
|
|
|