| Source HCPCS Code |
|
Target NDC Code |
J1301
Injection, edaravone, 1 mg
|
⇄
|
00781-3527-20
EDARAVONE 30 MG/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
01/31/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
00781-3527-94
EDARAVONE 30 MG/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
01/31/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
39822-4500-01
EDARAVONE 30 MG/100 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/01/2024 |
| Relationship End Date |
05/31/2026 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
39822-4500-02
EDARAVONE 30 MG/100 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/01/2024 |
| Relationship End Date |
05/31/2026 |
| Number Of Items In Ndc Package |
200 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
39822-4510-01
EDARAVONE 60 MG/100 ML VIAL
|
| Detail Information |
| Relationship Start Date |
12/01/2024 |
| Relationship End Date |
09/30/2026 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
66794-0259-61
EDARAVONE 30 MG/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
07/08/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
66794-0259-64
EDARAVONE 30 MG/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
07/08/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
70510-2171-01
RADICAVA 30 MG/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
01/01/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
70510-2171-02
RADICAVA 30 MG/100 ML BAG
|
| Detail Information |
| Relationship Start Date |
01/01/2019 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
70510-2171-02
Radicava
|
| 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 |
|
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
66794-0259-64
Edaravone
|
| 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 |
|
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
00781-3527-20
Edaravone
|
| 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 |
|
|
|
|
J1301
Injection, edaravone, 1 mg
|
⇄
|
39822-4500-02
Edaravone
|
| 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 |
|
|
|
|