| Source HCPCS Code |
|
Target NDC Code |
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
00143-9192-01
FOSCARNET 6,000 MG/250 ML BTTL
|
| Detail Information |
| Relationship Start Date |
10/04/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BOTTLE |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
INJECTION, FOSCARNET SODIUM, PER 1000 MG
|
⇄
|
00186-1905-01
FOSCAVIR 24 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
10/5/2005 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
GC |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
INJECTION, FOSCARNET SODIUM, PER 1000 MG
|
⇄
|
00186-1906-01
FOSCAVIR 24 MG/ML
|
| Detail Information |
| Relationship Start Date |
1/1/2002 |
| Relationship End Date |
4/9/2009 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
GC |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
INJECTION, FOSCARNET SODIUM, PER 1000 MG
|
⇄
|
00409-3863-02
FOSCARNET SODIUM (12X250ML,PF) 24 MG/ML
|
| Detail Information |
| Relationship Start Date |
2/1/2006 |
| Relationship End Date |
1/1/2012 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
GC |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
INJECTION, FOSCARNET SODIUM, PER 1000 MG
|
⇄
|
00409-3863-05
FOSCARNET SODIUM (12X500ML,PF) 24 MG/ML
|
| Detail Information |
| Relationship Start Date |
2/1/2006 |
| Relationship End Date |
2/1/2012 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
GC |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
23155-0771-31
FOSCARNET 6,000 MG/250 ML BTTL
|
| Detail Information |
| Relationship Start Date |
12/29/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BOTTLE |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
25021-0189-84
FOSCARNET 6,000 MG/250 ML B
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
43066-0089-10
FOSCARNET 6,000 MG/250 ML B
|
| Detail Information |
| Relationship Start Date |
04/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
63323-0875-50
FOSCARNET 6,000 MG/250 ML B
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BOTTLE |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
70121-1744-01
FOSCARNET 6,000 MG/250 ML BAG
|
| Detail Information |
| Relationship Start Date |
05/28/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
Injection, foscarnet sodium, per 1000 mg
|
⇄
|
70121-1744-02
FOSCARNET 6,000 MG/250 ML BAG
|
| Detail Information |
| Relationship Start Date |
05/28/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3000 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
BAG |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J1455
|
⇄
|
76310-0001-25
|
| 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 |
|
|
|
|
J1455
Foscarnet sodium injection
|
⇄
|
70121-1744-02
Foscarnet Sodium
|
| 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 |
|
|
|
|
J1455
Foscarnet sodium injection
|
⇄
|
43066-0089-10
Foscarnet Sodium
|
| 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 |
|
|
|
|
J1455
Foscarnet sodium injection
|
⇄
|
63323-0875-50
Foscarnet Sodium
|
| 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 |
|
|
|
|
J1455
Foscarnet sodium injection
|
⇄
|
00143-9192-01
Foscarnet Sodium
|
| 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 |
|
|
|
|
J1455
Foscarnet sodium injection
|
⇄
|
25021-0189-84
Foscarnet Sodium
|
| 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 |
|
|
|
|