| Source HCPCS Code |
|
Target NDC Code |
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
00054-1218-42
DOLOPHINE HCL (VIAL) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
6/1/2003 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
00406-1510-56
METHADONE HCL
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
00406-1510-57
METHADONE HCL
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
00406-1510-59
METHADONE HCL
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
17478-0380-20
METHADONE HCL 10 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
11/13/2017 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
38779-0104-03
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
38779-0104-04
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
38779-0104-05
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
49452-4553-01
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
6/1/2015 |
| Relationship End Date |
10/17/2016 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
49452-4553-02
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
6/1/2015 |
| Relationship End Date |
10/17/2016 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
49452-4553-03
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
6/1/2015 |
| Relationship End Date |
10/17/2016 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
51552-0728-01
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
09/01/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
51552-0728-02
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
09/01/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
51552-0728-04
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
09/01/2004 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
51927-1017-00
METHADONE HCL (U.S.P.; CII)
|
| Detail Information |
| Relationship Start Date |
09/08/2003 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
63275-9100-04
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
12/03/2002 |
| Relationship End Date |
05/31/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
63275-9100-05
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
12/03/2002 |
| Relationship End Date |
05/31/2021 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
63370-0939-15
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
63370-0939-25
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
63370-0939-35
METHADONE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
7/8/2003 |
| Relationship End Date |
5/31/2013 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
64019-0750-85
METHADONE HCL
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
64019-0750-88
METHADONE HCL
|
| Detail Information |
| Relationship Start Date |
01/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
66479-0530-02
METHADONE HYDROCHLORIDE (USP,MDV) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/9/2007 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
66591-0815-51
METHADONE HCL 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
12/12/2003 |
| Relationship End Date |
1/8/2007 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J1230
INJECTION, METHADONE HCL, UP TO 10 MG
|
⇄
|
66689-0681-55
METHADONE HCL
|
| Detail Information |
| Relationship Start Date |
02/01/2002 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1230
Injection, methadone hcl, up to 10 mg
|
⇄
|
67457-0217-20
METHADONE HCL 10 MG/ML VIAL
|
| Detail Information |
| Relationship Start Date |
02/05/2009 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
20 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J1230
Methadone injection
|
⇄
|
67457-0217-20
Methadone Hcl
|
| 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 |
|
|
|
|