| Source HCPCS Code |
|
Target NDC Code |
J1105
DEXMEDETOMIDINE, ORAL, 1 MCG
|
⇄
|
81092-1120-01
IGALMI (PEPPERMINT) 120 MCG
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SL |
| Billing Units |
EA |
|
|
|
J1105
DEXMEDETOMIDINE, ORAL, 1 MCG
|
⇄
|
81092-1180-01
IGALMI (PEPPERMINT) 180 MCG
|
| Detail Information |
| Relationship Start Date |
01/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
SL |
| Billing Units |
EA |
|
|
|
J1105
Dexmedetomidine film, 1 mcg
|
⇄
|
81092-1120-01
IGALMI
|
| 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 |
|
|
|
|
J1105
Dexmedetomidine film, 1 mcg
|
⇄
|
81092-1180-01
IGALMI
|
| 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 |
|
|
|
|