| Source HCPCS Code |
|
Target NDC Code |
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00264-7578-10
MANNITOL EXCEL 20%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00338-0353-03
OSMITROL VIAFLEX 10%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00338-0357-02
OSMITROL VIAFLEX 20%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00338-0357-03
OSMITROL VIAFLEX 20%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00409-4031-01
MANNITOL VIAL, FLIPTOP 25%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
Injection, mannitol, 250 mg
|
⇄
|
00409-4031-16
MANNITOL 25% (12.5 GM/50 ML)
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00990-7715-02
MANNITOL 20%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
250 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
00990-7715-03
MANNITOL 20%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
500 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
Injection, mannitol, 250 mg
|
⇄
|
63323-0024-01
MANNITOL 25% (12.5 GM/50 ML)
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
VIAL |
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2151
INJECTION, MANNITOL, 250 MG
|
⇄
|
63323-0024-25
MANNITOL 25%
|
| Detail Information |
| Relationship Start Date |
10/01/2025 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
50 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IJ |
| Billing Units |
ML |
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
63323-0024-25
Mannitol
|
| 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 |
|
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
00404-9905-50
Mannitol
|
| 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 |
|
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
51662-1468-01
Mannitol
|
| 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 |
|
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
51662-1468-03
Mannitol
|
| 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 |
|
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
00990-7715-02
Mannitol
|
| 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 |
|
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
00990-7715-03
Mannitol
|
| 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 |
|
|
|
|
J2151
Inj, mannitol, 250 mg
|
⇄
|
00409-4031-01
Mannitol
|
| 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 |
|
|
|
|