| Source HCPCS Code |
|
Target NDC Code |
J1414
INJECTION, FIDANACOGENE ELAPARVOVEC-DZKT, PER THERAPEUTIC DOSE
|
⇄
|
00069-2004-04
BEQVEZ 4 SDV KIT
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/11/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1414
INJECTION, FIDANACOGENE ELAPARVOVEC-DZKT, PER THERAPEUTIC DOSE
|
⇄
|
00069-2005-05
BEQVEZ 5 SDV KIT
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/11/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1414
INJECTION, FIDANACOGENE ELAPARVOVEC-DZKT, PER THERAPEUTIC DOSE
|
⇄
|
00069-2006-06
BEQVEZ 6 SDV KIT
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/11/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|
J1414
INJECTION, FIDANACOGENE ELAPARVOVEC-DZKT, PER THERAPEUTIC DOSE
|
⇄
|
00069-2007-07
BEQVEZ 7 SDV KIT
|
| Detail Information |
| Relationship Start Date |
01/01/2025 |
| Relationship End Date |
06/11/2025 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
EA |
|
|
|