| Source HCPCS Code |
|
Target NDC Code |
J1826
INJECTION, INTERFERON BETA-1A, 30 MCG
|
⇄
|
59627-0111-03
AVONEX (4 DOSE PACKS; S.D.V.) 30 MCG
|
| Detail Information |
| Relationship Start Date |
04/01/2015 |
| Relationship End Date |
05/31/2019 |
| Number Of Items In Ndc Package |
4 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
IM |
| Billing Units |
EA |
|
|
|
J1826
INJECTION, INTERFERON BETA-1A, 30 MCG
|
⇄
|
59627-0222-05
AVONEX (4 DOSE PACKS) 30 MCG/0.5 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|
J1826
INJECTION, INTERFERON BETA-1A, 30 MCG
|
⇄
|
59627-0333-04
AVONEX PEN (SINGLE USE,25G,5/8") 30 MCG/0.5 ML
|
| Detail Information |
| Relationship Start Date |
04/01/2015 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
EA |
| Ndc Package Type |
BX |
| Route Of Administration |
MR |
| Billing Units |
EA |
|
|
|