| Source HCPCS Code |
|
Target NDC Code |
J2267
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-1442-01
OMVOH 200 MG/2 ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
04/28/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J2267
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-3116-01
OMVOH 200 MG/2 ML PEN
|
| Detail Information |
| Relationship Start Date |
04/23/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
2 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J2267
INJECTION, MIRIKIZUMAB-MRKZ, 1 MG
|
⇄
|
00002-7575-01
OMVOH (SDV,PF,LATEX-FREE) 20 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
15 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
IV |
| Billing Units |
ML |
|
|
|
J2267
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-7717-11
OMVOH PEN 300 MG DOSE (100 MG/ML-200 MG/2 ML)
|
| Detail Information |
| Relationship Start Date |
04/23/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J2267
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-7722-11
OMVOH 300 MG DOSE (100 MG/ML-200 MG/2 ML)
|
| Detail Information |
| Relationship Start Date |
04/28/2025 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
3 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J2267
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-8011-01
OMVOH 100 MG/ML PEN
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J2267
INJECTION, MIRIKIZUMAB-MRKZ, 1 MG
|
⇄
|
00002-8011-27
OMVOH PEN (PREFILLED PEN,PF) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
|
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J2267
Injection, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-8870-01
OMVOH 100 MG/ML SYRINGE
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
12/31/3999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SYRINGE |
| Route Of Administration |
SQ |
| Billing Units |
ML |
|
|
|
J2267
INJECTION, MIRIKIZUMAB-MRKZ, 1 MG
|
⇄
|
00002-8870-27
OMVOH PREFILLED SYRINGE (PF,LATEX-FREE) 100 MG/1 ML
|
| Detail Information |
| Relationship Start Date |
07/01/2024 |
| Relationship End Date |
99/99/9999 |
| Number Of Items In Ndc Package |
1 |
| Ndc Package Measure |
ML |
| Ndc Package Type |
SY |
| Route Of Administration |
SC |
| Billing Units |
ML |
|
|
|
J2267
Inj, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-7575-01
Omvoh
|
| 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 |
|
|
|
|
J2267
Inj, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-7717-11
Omvoh
|
| 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 |
|
|
|
|
J2267
Inj, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-7722-11
Omvoh
|
| 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 |
|
|
|
|
J2267
Inj, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-8011-27
Omvoh
|
| 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 |
|
|
|
|
J2267
Inj, mirikizumab-mrkz, 1 mg
|
⇄
|
00002-8870-27
Omvoh
|
| 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 |
|
|
|
|