| Source HCPCS Code |
|
Target NDC Code |
J1812
Insulin (fiasp), per 5 units
|
⇄
|
00169-3201-11
FIASP 100 UNIT/ML VIAL
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
10 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1812
INSULIN (FIASP), PER 5 UNITS
|
⇄
|
00169-3204-15
FIASP FLEXTOUCH (PREFILLED PEN, SU) 100 U/1 ML
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CT |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J1812
Insulin (fiasp), per 5 units
|
⇄
|
00169-3205-11
FIASP PENFILL 100 UNIT/ML C
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CARTRIDGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J1812
INSULIN (FIASP), PER 5 UNITS
|
⇄
|
00169-3205-15
FIASP PENFILL (PREFILLED PEN) 100 U/1 ML
|
| Detail Information |
| Relationship Start Date |
07/01/2023 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
CT |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|