| Source HCPCS Code |
|
Target NDC Code |
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
00310-0049-10
ELAVIL (M.D.V.) 10 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
5/12/2003 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VL |
| Route Of Administration |
IM |
| Billing Units |
ML |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
38779-0189-03
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
10/01/2012 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
5 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
38779-0189-04
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
10/01/2012 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
25 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
38779-0189-05
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
10/01/2012 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
100 |
| Ndc Package Measure |
GM |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
49452-0460-01
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
49452-0460-02
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
49452-0460-03
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
51552-0464-02
AMITRIPTYLINE HCL (1X5GM)
|
| 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
51552-0464-04
AMITRIPTYLINE HCL
|
| Detail Information |
| Relationship Start Date |
9/1/2003 |
| Relationship End Date |
5/6/2008 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
51552-0464-05
AMITRIPTYLINE HCL (1X100GM)
|
| 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
51552-0464-06
AMITRIPTYLINE HCL (1X500GM)
|
| 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 |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
|
⇄
|
51552-0464-07
|
| 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 |
|
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
51552-0464-25
AMITRIPTYLINE HCL
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
8/31/2003 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
51927-1603-00
AMITRIPTYLINE HCL (U.S.P.)
|
| 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 |
JR |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
62991-2004-01
AMITRIPTYLINE HCL (U.S.P.)
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
|
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BO |
| Route Of Administration |
NA |
| Billing Units |
GM |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
62991-2004-02
AMITRIPTYLINE 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
62991-2004-03
AMITRIPTYLINE 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63275-9936-02
AMITRIPTYLINE HYDROCHLORIDE (1X5GM, USP)
|
| Detail Information |
| Relationship Start Date |
01/01/2007 |
| 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63275-9936-04
AMITRIPTYLINE HYDROCHLORIDE (1X25GM, USP)
|
| Detail Information |
| Relationship Start Date |
01/01/2007 |
| 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63275-9936-05
AMITRIPTYLINE HYDROCHLORIDE (1X100GM, USP)
|
| Detail Information |
| Relationship Start Date |
01/01/2007 |
| 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63275-9936-08
AMITRIPTYLINE HYDROCHLORIDE (1X500GM, USP)
|
| Detail Information |
| Relationship Start Date |
01/01/2007 |
| 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63370-0018-15
AMITRIPTYLINE 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63370-0018-25
AMITRIPTYLINE 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 |
|
|
|
J1320
INJECTION, AMITRIPTYLINE HCL, UP TO 20 MG
|
⇄
|
63370-0018-35
AMITRIPTYLINE 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 |
|
|
|